Sex-Specific Predictive Value of Obesity-Related Indicators for Diabetic Kidney Disease in Type 2 Diabetes Mellitus.

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.