Association between metabolic phenotype and diabetic kidney disease in adult-onset type 1 diabetes patients from China: A multi-center cross-sectional study.

AIM: To explore the association of different metabolic phenotypes with diabetic kidney disease (DKD) and high DKD progression risk in adult-onset type 1 diabetes mellitus (T1DM) patients from China.

METHODS

According to body mass index (BMI) and metabolic risk factors, the patients were divided into six metabolic phenotypes. The proportions of metabolic phenotypes were investigated. Logistic regression models were used to explore the association of different metabolic phenotypes with DKD and high DKD progression risk in adult-onset T1DM patients, and the odds ratio (OR) and 95 % confidence interval (CI) of each metabolic phenotype were calculated.

RESULTS

In 433 adult-onset T1DM patients, Phenotype 4 (T1DM with underweight metabolically unhealthy phenotype) (OR = 1.86, 95 % CI:1.35-2.57, P < 0.001) was correlated with moderate albuminuria, while phenotype 3 (T1DM with overweight metabolically healthy phenotype) (OR = 1.84, 95 % CI:1.03-3.28, P = 0.04) and phenotype 4 (OR = 1.73, 95 % CI:1.13-2.67, P = 0.01) both had an independent positive correlation with abnormal kidney function. Phenotype 4 (OR = 45.14, 95 % CI:7.69-264.95, P < 0.001) and phenotype 5 (T1DM with normal weight metabolically unhealthy phenotype) (OR = 5.59, 95 % CI:1.10-28.34, P = 0.038) both had an independent positive association with the high risk of DKD progression.

CONCLUSION

In adult-onset T1DM patients, the T1DM with underweight metabolically unhealthy phenotype was associated with moderate albuminuria, abnormal kidney function, and high risk of DKD progression. These findings suggest that underweight with metabolic abnormalities was a risk factor for DKD and DKD progression.