Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 538-550
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.538
Impact of body mass index on adverse kidney events in diabetes mellitus patients: A systematic-review and meta-analysis
Jing-Fang Wan, Yan Chen, Tian-Hua Yao, Ya-Zhou Wu, Huan-Zi Dai
Jing-Fang Wan, Department of Nephrology, Army Medical University, Chongqing 400042, China
Yan Chen, Department of Nephrology, Chongqing Western Hospital, Chongqing 400052, China
Tian-Hua Yao, Ya-Zhou Wu, Health Statistics, Army Medical University, Chongqing 400038, China
Huan-Zi Dai, Department of Nephrology, Daping Hospital, Army Medical University, Chongqing 400042, China
Co-first authors: Jing-Fang Wan and Yan Chen.
Co-corresponding authors: Ya-Zhou Wu and Huan-Zi Dai.
Author contributions: Wan JF, Chen Y, Dai HZ and Wu YZ conceived, designed and refined the study protocol; Wan JF and Chen Y and Yao TH were involved in the data collection; Wan JF, Yao TH, Dai HZ and Wu YZ analyzed the data; Wan JF, Chen Y, Dai HZ and Wu YZ drafted the manuscript; Dai HZ and Wu YZ contributed to review and editing, and final approval. All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript.; Wan JF and Chen Y contributed equally to this work as co-first authors; Wu YZ and Dai HZ contributed equally to this work as co-corresponding authors. The reasons for designating Wu YZ and Dai HZ as co-corresponding authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-corresponding authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Wu YZ and Dai HZ contributed efforts of equal substance throughout the research process. The choice of these researchers as co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Wu YZ and Dai HZ as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by Special Project for Improving Science and Technology Innovation Ability of Army Medical University, No. 2022XLC09.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huan-Zi Dai, MD, PhD, Associate Chief Physician, Associate Professor, Department of Nephrology, Daping Hospital, Army Medical University, No. 10 Daping Changjiang Zhi Road, Yuzhong District, Chongqing 400042, China. daihzxyz@163.com
Received: October 24, 2023
Peer-review started: October 24, 2023
First decision: November 22, 2023
Revised: December 10, 2023
Accepted: December 28, 2023
Article in press: December 28, 2023
Published online: January 26, 2024
Processing time: 86 Days and 5.5 Hours
ARTICLE HIGHLIGHTS
Research background

Obesity and diabetes are global public health concerns. Poor control of weight or blood sugar may lead to damage to multiple organs, including the kidneys.

Research motivation

The effect of obesity on adverse renal effects in patients with diabetes remains unclear.

Research objectives

This study aimed to explore the impact of body mass index (BMI) on adverse kidney events in patients with diabetes mellitus (DM).

Research methods

A systematic literature search was performed of the PubMed, ISI Web of Science, Scopus, Ovid, Google Scholar, EMBASE, and BMJ databases. We included trials with the following characteristics: (1) Type of study: Prospective, retrospective, randomized, and non-randomized in design; (2) participants: Restricted to patients with DM aged ≥ 18 years; (3) intervention: No intervention; (4) kidney adverse events: onset of diabetic kidney disease [estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m2 and/or microalbuminuria value of ≥ 30 mg/g Cr], serum creatinine increase of more than double the baseline or end stage renal disease (eGFR < 15 mL/min/1.73 m2 or dialysis), or death.

Research results

High BMI (≥ 25 kg/m2) was significantly associated with higher blood pressure, serum albumin, triglycerides, low-density lipoprotein cholesterol, and lower high-density lipoprotein cholesterol levels in patients with DM than in those with low BMIs (< 25 kg/m2). Our analysis showed that a high BMI was associated with a higher risk ratio of adverse kidney events than a low BMI.

Research conclusions

High BMI was identified as a risk factor contributing to adverse kidney events in patients with DM.

Research perspectives

A larger sample size and higher quality studies are warranted to corroborate the findings of this meta-analysis, and future studies focusing on the optimal weight range for patients with DM would also be beneficial.