Interactive effects of intrinsic capacity and obesity on the KDIGO chronic kidney disease risk classification in older patients with type 2 diabetes mellitus

Diabetology & Metabolic Syndrome

Research

Teng-Hung Yu¹  Wei-Hua Tang²  Hui-Lan Lee³  Yau-Jiunn Lee⁴ 

[1] Division of Cardiology, Department of Internal Medicine, E-Da Hospital, 82445, Kaohsiung, Taiwan;School of Medicine, College of Medicine, I-Shou University, 82445, Kaohsiung, Taiwan;Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, 98142, Hualien, Taiwan;Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, 112304, Taipei, Taiwan;Health Promotion Administration, Ministry of Health and Welfare, 10320, Taipei, Taiwan;Lee’s Endocrinologic Clinic, No. 130 Min-Tzu Rd, 90000, Pingtung, Taiwan;

关键词: KDIGO chronic kidney disease risk classification;    Intrinsic capacity;    Obesity;    Synergistic interaction;    Type 2 diabetes mellitus;   

DOI  :  10.1186/s13098-022-00975-x

 received in 2022-07-05, accepted in 2022-12-27,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundIntrinsic capacity (IC) is a novel concept focusing on normal and healthy aging. The effect of IC on the risk of chronic kidney disease (CKD) according to KDIGO category in older type 2 diabetes mellitus (T2DM) patients has rarely been studied. We investigated whether a decline in IC is associated with the risk of CKD according to KDIGO 2012 categories.MethodsThis is a cross-sectional study. The exposure variables (IC score and body mass index) and outcome variable (KDIGO categories of the risk of CKD) were collected at the same timepoint. A total of 2482 older subjects with T2DM managed through a disease care program were enrolled. The five domains of IC, namely locomotion, cognition, vitality, sensory, and psychological capacity were assessed. Based on these domains, the IC composite score was calculated. CKD risk was classified according to the KDIGO 2012 CKD definition. Univariate and multivariate analyses were used to assess the association between IC score and KDIGO categories of risk of CKD.ResultsThe KDIGO CKD risk category increased in parallel with IC score (p for trend < 0.0001). In multivariate analysis, compared to those with an IC score 0, the odds ratio of having a KDIGO moderately increased to very high risk category of CKD was 1.76 (1.31–2.37) times higher for those with an IC score of 2–5. Furthermore, an increased IC score was associated with a higher prevalence of moderate and severe obesity. Moreover, there was a synergistic interaction between IC score and obesity on the KDIGO moderately increased to very high risk category of CKD (synergy index = 1.683; 95% CI 0.630–3.628), and the proportion of the KDIGO moderately increased to very high risk category of CKD caused by this interaction was 25.6% (attributable proportion of interaction = 0.256).ConclusionsOur findings indicate that IC score may be closely related to the KDIGO moderately increased to very high risk category of CKD. In addition, there may be a synergistic interaction between IC score and obesity, and this synergistic interaction may increase the KDIGO CKD risk stage.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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