Jing Mao, Shijun Gong, Jing Jin, Yajuan Tan, Ling Zeng, Quan Zhou, Fang Yu, Haifeng Zhou, Huilin Lu, Shenglian Gan
The optimal predictors of DKD in T2DM patients were gender-specific: TyG-BMI in males and TyG-WHtR in females. TyG-WHtR should be closely monitored in female T2DM patients (especially those with SBP ≥ 140 mmHg) to enable early identification and intervention for DKD risk. These gender-specific indices may provide preliminary evidence for early DKD risk stratification.
PURPOSE: Obesity is a significant risk factor for diabetic kidney disease (DKD). However, the relationship between obesity-related indicators and DKD is controversial. The aim of this study was to investigate the gender-specific differences in predictive performance of eight obesity-related indicators concerning DKD risk among type 2 diabetes mellitus (T2DM) patients.
METHODS: This cross-sectional study analyzed data from 1586 T2DM patients aged 18-80 years. The exposure variables included body mass index (BMI), triglyceride-glucose index (TyG), Chinese visceral adiposity index (CVAI), visceral adiposity index (VAI), and TyG-related composite indicators, which are TyG-waist circumference (TyG-WC), TyG-body mass index (TyG-BMI), TyG-waist-hip ratio (TyG-WHpR), and TyG-waist-height ratio (TyG-WHtR). Point-biserial correlation analysis, multivariate logistic regression, receiver operating characteristic (ROC) curve, subgroup analyses, and interaction tests were used to explore the correlation between these indicators and DKD.
RESULTS: The prevalence of DKD in the studied T2DM patients was 37.3%. All eight obesity-related indicators were independently and positively associated with DKD. TyG-BMI had the largest AUC (0.6195) for predicting DKD in males, with a cut-off value of 53.3250. TyG-WHtR had the highest AUC (0.6213) for DKD in females, with a cut-off value of 1.0234. TyG-WHtR was more strongly associated with DKD in T2DM patients with systolic blood pressure (SBP) ≥ 140 mmHg, according to subgroup analysis (P for interaction = 0.0265).
CONCLUSION: The optimal predictors of DKD in T2DM patients were gender-specific: TyG-BMI in males and TyG-WHtR in females. TyG-WHtR should be closely monitored in female T2DM patients (especially those with SBP ≥ 140 mmHg) to enable early identification and intervention for DKD risk. These gender-specific indices may provide preliminary evidence for early DKD risk stratification.