Association of obesity-related indices with chronic kidney disease risk in diabetes: A cross-sectional study

Table 1 Baseline demographic and clinical characteristics of the study population

Characteristic	Non-CKD (n = 3070)	CKD (n = 456)	P value
Age (years)	51.00 (47.00-57.00)	52.00 (46.00-59.00)	0.114
Sex (male)	2479 (80.7)	392 (86.0)	0.007b
Blood pressure (kPa)	16.93 (15.33-18.53)/10.80 (9.87-11.73)	18.67 (16.67-20.27)/11.73 (10.63-12.80)	< 0.001b
Pulse (bpm)	74.00 (67.00-80.00)	77.00 (69.00-84.00)	< 0.001b
Smoking	1647 (53.6)	247 (54.2)	0.841
Drinking	2058 (67.0)	311 (68.2)	0.631
Marriage			0.878
Single status	84 (2.7)	13 (2.9)
Marital status	2986 (97.3)	443 (97.1)
Dyslipidemia	452 (14.7)	79 (17.3)	0.160
Hypertension	1426 (46.4)	286 (62.7)	< 0.001b
WBC (× 109/L)	6.07 (5.21-7.15)	6.53 (5.53-7.80)	< 0.001b
RBC (× 1012/L)	4.88 (4.57-5.15)	4.94 (4.64-5.29)	< 0.001b
Hb (g/dL)	15.00 (14.00-15.80)	15.10 (14.20-16.10)	0.002b
PLT (× 109/L)	211.00 (179.00-246.00)	215.00 (178.75-252.25)	0.267
TC (mmol/L)	4.77 (4.11-5.50)	4.94 (4.07-5.70)	0.186
TG (mmol/L)	1.84 (1.29-2.71)	2.10 (1.52-3.54)	< 0.001b
LDL-C (mmol/L)	3.08 (2.45-3.69)	3.02 (2.36-3.72)	0.486
HDL-C (mmol/L)	1.06 (0.90-1.27)	1.03 (0.89-1.21)	0.024a
hs-CRP (mg/L)	1.30 (0.70-2.40)	1.60 (0.90-3.40)	< 0.001b
ALT (U/L)	24.00 (16.90-35.00)	25.70 (17.50-36.82)	0.054
AST (U/L)	19.00 (15.50-24.20)	20.15 (15.97-27.00)	0.002b
GGT (U/L)	36.80 (23.00-60.83)	42.00 (28.00-68.25)	< 0.001b
ALP (U/L)	67.00 (55.00-80.00)	69.00 (58.00-84.00)	< 0.001b
ALB (g/L)	45.50 (43.20-47.70)	45.50 (43.10-48.00)	0.885
TBIL (μmol/L)	10.80 (8.30-14.30)	10.80 (8.60-14.30)	0.578
SUA (μmol/L)	346.00 (293.00-404.00)	362.00 (309.00-429.85)	< 0.001b
Hcy (μmol/L)	11.97 (9.30-15.15)	12.80 (9.88-16.22)	< 0.001b
FPG (mmol/L)	7.24 (6.24-8.39)	7.86 (6.70-10.07)	< 0.001b
FINS (pmol/L)	76.60 (51.60-113.40)	94.60 (63.70-138.50)	< 0.001b
FCP (nmol/L)	0.91 (0.70-1.14)	1.03 (0.78-1.27)	< 0.001b
TyG	9.28 (8.86-9.77)	9.52 (9.09-10.15)	< 0.001b
HbA1c (%)/mmol/mol	6.80 (6.30-7.50)/50 (46-58)	7.10 (6.60-8.50)/54 (47-69)	< 0.001b
GA (%)	16.40 (14.60-18.70)	17.05 (15.10-21.12)	< 0.001b
BUN (mg/dL)	14.60 (12.60-17.10)	15.10 (12.60-17.90)	0.020a
SCr (μmol/L)	67.00 (58.00-76.00)	69.00 (58.00-80.00)	0.006b
eGFR (mL/minute/1.73 m2)	103.78 (97.36-110.31)	103.50 (91.21-111.03)	0.027a
ACR (mg/g)	5.60 (3.80-9.27)	71.69 (41.18-166.37)	< 0.001b
BMI (kg/m2)	26.30 (24.40-28.50)	27.80 (25.60-29.90)	< 0.001b
RFM	28.29 (25.94-31.44)	29.23 (26.94-32.10)	< 0.001b
CVAI	130.00 (105.63-155.36)	146.96 (124.58-174.38)	< 0.001b
WHtR	0.54 (0.51-0.58)	0.56 (0.53-0.60)	< 0.001b
VAI	2.47 (1.55-4.04)	2.88 (1.85-5.28)	< 0.001b
BRI	4.23 (3.62-4.93)	4.65 (4.02-5.46)	< 0.001b
ABSI	0.08 (0.07-0.09)	0.08 (0.08-0.08)	0.071
LAP	54.08 (34.46-85.27)	71.07 (48.02-117.81)	< 0.001b
WTI	173.89 (118.41-259.66)	203.88 (144.44-339.27)	< 0.001b
C-index	1.27 (1.23-1.32)	1.29 (1.24-1.34)	< 0.001b

^aP < 0.05.

^bP < 0.01.

The Wilcoxon rank-sum test was used to analyze non-normally distributed data. The χ² test was used to compare categorical variables. Values are presented as median (interquartile range) for continuous variables, and as n (%) for categorical variables. bpm: Beats per minute; WBC: White blood cell count; RBC: Red blood cell count; Hb: Hemoglobin; PLT: Platelet count; TC: Total cholesterol; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; hs-CRP: High-sensitivity C-reactive protein; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Γ-glutamyl transferase; ALP: Alkaline phosphatase; ALB: Albumin; TBIL: Total bilirubin; SUA: Serum uric acid; Hcy: Homocysteine; FPG: Fasting plasma glucose; FINS: Fasting insulin; FCP: Fasting C-peptide; TyG: Triglyceride-glucose index; HbA1c: Glycated hemoglobin A1c; GA: Glycated albumin; BUN: Blood urea nitrogen; SCr: Serum creatinine; eGFR: Estimated glomerular filtration rate; ACR: Albumin-to-creatinine ratio; BMI: Body mass index; RFM: Relative fat mass; CVAI: Chinese visceral adiposity index; WHtR: Waist-to-height ratio; VAI: Visceral adiposity index; BRI: Body roundness index; ABSI: A body shape index; LAP: Lipid accumulation product; WTI: Waist-triglyceride index; C-index: Conicity index.

Table 2 Multivariable logistic regression analyses of the associations between obesity-related indices and chronic kidney disease risk

Indices	Model 1			Model 2			Model 3
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
BMI	1.55	1.41-1.70	< 0.001b	1.56	1.42-1.72	< 0.001b	1.51	1.36-1.67	< 0.001b
RFM	1.16	1.06-1.28	< 0.001b	1.21	1.08-1.35	< 0.001b	1.18	1.05-1.31	< 0.001b
CVAI	1.63	1.48-1.80	< 0.001b	1.63	1.47-1.82	< 0.001b	1.57	1.41-1.76	< 0.001b
WHtR	1.53	1.39-1.68	< 0.001b	1.51	1.37-1.67	< 0.001b	1.46	1.32-1.61	< 0.001b
VAI	1.22	1.12-1.32	< 0.001b	1.24	1.14-1.34	< 0.001b	1.23	1.13-1.33	< 0.001b
BRI	1.51	1.37-1.66	< 0.001b	1.49	1.35-1.64	< 0.001b	1.44	1.31-1.59	< 0.001b
LAP	1.35	1.25-1.46	< 0.001b	1.38	1.27-1.49	< 0.001b	1.35	1.24-1.47	< 0.001b
WTI	1.28	1.18-1.39	< 0.001b	1.31	1.20-1.42	< 0.001b	1.29	1.19-1.40	< 0.001b
C-index	1.29	1.16-1.42	< 0.001b	1.24	1.12-1.38	< 0.001b	1.21	1.09-1.35	< 0.001b

^bP < 0.01.

Model 1 Unadjusted. Model 2 was adjusted for sex, age, smoking, drinking, and marital status. Model 3 was additionally adjusted for hypertension and dyslipidemia. For relative fat mass, sex was not additionally adjusted because it is embedded in the relative fat mass calculation. Models additionally including sex are shown in Supplementary Table 3. CI: Confidence interval; OR: Odds ratio; BMI: Body mass index; RFM: Relative fat mass; CVAI: Chinese visceral adiposity index; WHtR: Waist-to-height ratio; VAI: Visceral adiposity index; BRI: Body roundness index; ABSI: A body shape index; LAP: Lipid accumulation product; WTI: Waist-triglyceride index; C-index: Conicity index.

Table 3 Comparative receiver operating characteristic curve analysis of 10 obesity-related indices for discriminating chronic kidney disease

Obesity indices	CKD
	AUC	95%CI
BMI	0.625	0.597-0.652
RFM	0.562	0.535-0.589
CVAI	0.637	0.610-0.663
WHtR	0.620	0.593-0.647
VAI	0.572	0.544-0.600
BRI	0.620	0.593-0.647
ABSI	0.526	0.498-0.554
LAP	0.617	0.590-0.644
WTI	0.595	0.567-0.623
C-index	0.571	0.543-0.599

CKD: Chronic kidney disease; BMI: Body mass index; RFM: Relative fat mass; CVAI: Chinese visceral adiposity index; WHtR: Waist-to-height ratio; VAI: Visceral adiposity index; BRI: Body roundness index; ABSI: A body shape index; LAP: Lipid accumulation product; WTI: Waist-triglyceride index; C-index: Conicity index; AUC: Area under the curve; CI: Confidence interval.