國家衛生研究院 NHRI:Item 3990099045/10197
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    题名: Obesity, weight change, and chronic kidney disease in patients with Type 2 diabetes mellitus: A longitudinal study in Taiwan
    作者: Chung, HF;Al Mamun, A;Huang, MC;Long, KZ;Huang, YF;Shin, SJ;Hwang, SJ;Hsu, CC
    贡献者: Division of Health Services and Preventive Medicine
    摘要: BACKGROUND: We investigated obesity and weight change in relation to risk of chronic kidney disease (CKD) in Asian patients with Type 2 diabetes using longitudinal data. METHODS: We recruited 1187 diabetic patients aged 30-70 years at baseline (2003-2005), and follow-up surveys were completed in 2008, 2009, and 2010. CKD was defined as having an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 ; body mass index (BMI; kg/m2 ) was categorised as normal (18.5-22.9), overweight (23-27.4), and obesity (>/=27.5); waist circumference (WC; cm) was categorised as normal and abdominal obesity (>/=80 for women, >/=90 for men). Weight/WC changes (%) were calculated between baseline and each follow-up survey. Generalized estimating equation models were used to estimate RR (95%CIs) of CKD. To estimate the risk for incident CKD, we examined the associations in patients without CKD at baseline (n = 881). RESULTS: During seven years of follow-up, obese BMI (RR:1.48, 1.08-2.04, p = 0.015) and excessive WC (RR:1.23, 1.00-1.52, p = 0.049) were associated with CKD after adjustment for covariates. Among CKD-free participants, patients who gained weight >10% (RR:1.43, 1.07-1.90, p = 0.015) and increased WC >15% (RR:1.37, 1.01-1.85, p = 0.045) had a higher risk of incident CKD compared with those who remained stable (+/-5%). The risks remained unchanged after adjusting for diabetic retinopathy and albuminuria. We also found a significant relationship between weight gain (per 1%) and eGFR decline (-0.04 mL/min/1.73 m2 /year, 95%CI:-0.07 to -0.02, p = 0.001). CONCLUSIONS: Diabetic patients with obese BMI and excessive central fat were more likely to have CKD. Large weight gain >10% and WC increase >15% independently predicted incident CKD.
    日期: 2016-12-15
    關聯: Journal of Diabetes. 2017 Nov;9(11):983-993.
    Link to: http://dx.doi.org/10.1111/1753-0407.12514
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1753-0393&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000413303300003
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85013066201
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