Objective
To investigate the correlation between body compositions (body fat, skeletal muscle, lean tissue) and diabetic retinopathy (DR) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).
Methods
A total of 1 017 hospitalized T2DM patients (582 males and 435 females) in our hospital from March 2013 to September 2016 were enrolled. According to their medical history and corresponding auxiliary examination, they were divided into four groups: T2DM with DKD group (n=389), T2DM without DKD group (n=628); and T2DM with DR group (n=288), T2DM without DR group (n=729). The clinical data and anthropological measurements were collected and body compositions, including total body fat (TBF), fat mass index (FMI), visceral adipose tissue (VAT), appendage lean mass/ height2 (ALMH), total lean mass (TLM), et al, were measured by dual-energy X-ray absorptiometry. The correlations between body compositions and DKD or DR were analyzed. The t test, U test, Chi square test analysis were used for statistical analysis. Logistic regression was used to estimate the association of body compositions with DKD or DR.
Results
There were statistically significant differences in T2DM duration, hypertension history, age, systolic blood pressure (SBP), low-density lipoprotein-cholesterol, triglyceride and uric acid (UA) between T2DM patients with DKD and those without DKD (all P 0.05). Multivariate logistic regression was used to correct the confounding factors such as HbA1c, total cholesterol, TLM, ALMH, gender, age, duration of T2DM etc. The risk of DKD in patients with T2DM was significantly increased with the increase of VAT [low rank as a reference, median rank OR=1.73, 95%CI (1.14, 2.62), high rank OR=2.47, 95%CI (1.45, 4.22)] and was not related with FMI. In the DR group, both VAT and FMI were not significantly associated with the risk of DR (P>0.05).
Conclusion
VAT is an independent risk factor for DKD.
Key words:
Diabetic kidney disease; Diabetic retinopathy; Body compositions; Risk factors