Shi YH, Zhang TJ, He F, Kang GB. Glycemic status, adiposity indices and cardiovascular risk in chronic kidney disease: Core findings from a nationwide cohort study. World J Diabetes 2026; 17(6): 117740 [DOI: 10.4239/wjd.117740]
Corresponding Author of This Article
Guo-Bin Kang, Academic Fellow, First Department of Cardiology, Hebei Provincial Hospital of Chinese Medicine/The First Affiliated Hospital of Hebei University of Chinese Medicine, No. 389 Zhongshan East Road, Chang’an District, Shijiazhuang 050000, Hebei Province, China. kanggb1229@126.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
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review-article
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Shi YH, Zhang TJ, He F, Kang GB. Glycemic status, adiposity indices and cardiovascular risk in chronic kidney disease: Core findings from a nationwide cohort study. World J Diabetes 2026; 17(6): 117740 [DOI: 10.4239/wjd.117740]
World J Diabetes. Jun 15, 2026; 17(6): 117740 Published online Jun 15, 2026. doi: 10.4239/wjd.117740
Glycemic status, adiposity indices and cardiovascular risk in chronic kidney disease: Core findings from a nationwide cohort study
Yan-Hui Shi, Tie-Jun Zhang, Fang He, Guo-Bin Kang
Yan-Hui Shi, Tie-Jun Zhang, Guo-Bin Kang, First Department of Cardiology, Hebei Provincial Hospital of Chinese Medicine/The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Fang He, Department of Medical Service, Hebei Provincial Hospital of Chinese Medicine/The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Author contributions: Shi YH and Kang GB led the revision of the manuscript; Shi YH revised and corrected the manuscript comprehensively again; Zhang TJ critically evaluated the review article and edited the manuscript accordingly; He F was responsible for examining pertinent literature and organizing the arguments to substantiate the line of inquiry; Kang GB is responsible for refining the academic language, harmonizing the author’s viewpoints, and facilitating communication with the editorial team. All authors collectively examined and approved the final version of the manuscript.
AI contribution statement: The manuscript uses DeepL to enhance the linguistic quality of certain sections. The entirety of the manuscript’s content was independently authored and was not produced by AI. This manuscript did not use any AI tools in the analysis or interpretation of the research findings.
Supported by the Project of Scientific Research Program of Hebei Provincial Administration of Traditional Chinese Medicine, No. 2026005; and Government Funded Clinical Medicine Talent Training Project, No. ZF2026240.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Guo-Bin Kang, Academic Fellow, First Department of Cardiology, Hebei Provincial Hospital of Chinese Medicine/The First Affiliated Hospital of Hebei University of Chinese Medicine, No. 389 Zhongshan East Road, Chang’an District, Shijiazhuang 050000, Hebei Province, China. kanggb1229@126.com
Received: December 15, 2025 Revised: February 3, 2026 Accepted: April 13, 2026 Published online: June 15, 2026 Processing time: 178 Days and 22 Hours
Abstract
The studies highlights that diabetic patients who are underweight and have small waist circumference face the highest risk of cardiovascular disease. Among patients with normal glucose levels, being underweight and having central obesity increases risk, while low weight is a consistent risk factor for those with impaired fasting glucose. These findings offer valuable insights for personalized risk stratification in chronic kidney disease (CKD) patients. We cautiously suggest five recommendations: (1) Considering enhanced body composition assessments, such as measurement of body fat percentage and muscle mass via dual-energy X-ray absorptiometry; (2) Refining risk models according to CKD stages; (3) The integration of long-term glycemic control metrics, such as hemoglobin A1c; (4) Conducting intervention studies to develop targeted treatment strategies; and (5) Validating the findings across diverse ethnic populations. Furthermore, we synthesize recent evidence concerning sarcopenia, emerging adiposity indices, and the cardiovascular risk-modulating effects of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in CKD. By addressing these existing knowledge gaps, this approach seeks to enhance the translation of epidemiological findings into clinical practice, thereby improving cardiovascular risk management within the expanding CKD patient population.
Core Tip: This study found that diabetes patients with underweight and low waist circumference had the highest risk of cardiovascular disease. Normal blood sugar levels, low body weight and central obesity increase the risk, while low body weight is a persistent risk factor for individuals with impaired fasting blood sugar. These findings provide insights into personalized risk stratification for chronic kidney disease. We suggest using dual-energy X-ray absorptiometry to assess body composition, improving the risk model based on chronic kidney disease staging, adding long-term glycemic control metrics, conducting intervention studies and verifying the research results in different ethnic populations.
