Effect of body shape index trajectories on kidney disease incidence and subsequent death in individuals with type 2 diabetes.

BACKGROUND

This study aimed to identify three-year trajectories of body mass index (BMI), a body shape index (ABSI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body roundness index (BRI); to assess their association with incident chronic kidney disease (CKD) and mortality; and to investigate potential sex difference in these associations.

METHODS

This retrospective longitudinal study included 8,445 patients with type 2 diabetes mellitus (T2DM) who were free of CKD at baseline, had ≥ 3 years of follow-up, and attended the Diabetes Care Management Program of a medical center in Taichung from 2001 to 2012 (with the follow-up period ending in 2021). Cluster analysis was performed to group three-year trajectory patterns, and Cox proportional hazard models were used to assess the associations.

RESULTS

During a mean follow-up of 7.88 years, 2,901 (34.35%) participants developed CKD, and 856 (10.14%) died. An elevated risk of CKD incidence was associated with several trajectory clusters. Specifically, associations were found with: Cluster 1 (constant low-level) for ABSI, WC, WHtR, and BRI trajectories; Cluster 4 (high level with decreasing trend) for WC and BRI trajectories; and Cluster 5 (low level with increasing trend) for BMI, WC, WHtR, and BRI trajectories. Regarding mortality, an elevated risk was associated with: Cluster 1 (constant low-level) for WC and WHtR trajectories; Cluster 3 (constant high-level) for ABSI and BRI trajectories; and Cluster 5 (low level with increasing trend) for BMI trajectory.

CONCLUSION

Longitudinal trajectories of various body shape indices predict CKD incidence and mortality risk in T2DM.