Weight management has long been recognized as a key preventive strategy against diabetic nephropathy, a serious kidney complication in patients with diabetes. However, the effect of large fluctuations in body fat levels during the weight control process on the risk of developing diabetic nephropathy remains unclear. This study investigates the relationship between body fat variation and the incidence of diabetic nephropathy in American patients with type 2 diabetes.
Methods
Using data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, researchers analyzed body fat variation rates over a two-year period. Participants were divided into two groups based on their body fat variation: Low and High. The study employed a Cox proportional hazards model to estimate the hazard ratio (HR) and 95% confidence interval (CI), while addressing confounding factors through propensity score matching.
Results
The study followed 4,609 participants with type 2 diabetes over five years, observing 1,511 cases of diabetic nephropathy. Findings revealed that individuals with a high body fat variation rate were at greater risk of developing diabetic nephropathy compared to those with a low variation rate (HR 1.13, 95% CI 1.01–1.26). A significant interaction between body fat variation and body mass index (BMI) was detected (P interaction = 0.008). Notably, the increased risk was primarily observed in participants with a BMI over 30 (HR 1.34, 95% CI 1.08–1.66), indicating a stronger association in obese individuals.
Conclusions
The study concluded that body fat variation is linked to a heightened risk of diabetic nephropathy in patients with type 2 diabetes. This association is particularly pronounced in obese individuals, while non-obese patients did not show a significant correlation. For obese patients with diabetes, a more gradual approach to weight loss may be beneficial in preventing excessive body fat fluctuations and reducing the risk of diabetic nephropathy.
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