Association of dysfunctional adiposity index with kidney impairment is accounted for by pigment epithelium-derived factor in type 2 diabetes mellitus – An 11-year follow-up of the SMART2D cohort study

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-02-01 DOI:10.1016/j.jdiacomp.2025.108953

Mei Chung Moh , Serena Low , Sharon Li Ting Pek , Jian-jun Liu , Keven Ang , Wern Ee Tang , Ziliang Lim , Tavintharan Subramaniam , Chee Fang Sum , Su Chi Lim

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引用次数: 0

Abstract

Aims

This novel longitudinal study investigated the association of the new dysfunctional adiposity index (DAI) with kidney impairment in multi-ethnic Asians with type 2 diabetes mellitus (T2DM), and the mediation effect of pigment epithelium-derived factor (PEDF).

Methods

T2DM adults followed for up to 10.5 years were analyzed (n = 1611). DAI was calculated using a sex-specific formula. Baseline plasma PEDF levels were quantified using immunoassay. Diabetic kidney disease (DKD) was defined as presence of chronic kidney disease and/or albuminuria. The longitudinal outcomes included ≥40 % decline in estimated glomerular filtration rate from baseline (significant eGFR decline), albuminuria progression, and end-stage kidney disease (ESKD).

Results

Baseline DAI was associated with kidney parameters and DKD cross-sectionally, and showed increased discrimination ability. DAI was correlated with PEDF (rho = 0.324, P < 0.001). Additionally, DAI predicted significant eGFR decline (35.8 % prevalence) in the unadjusted (hazard ratio = 1.49, 95 % CI:1.31–1.70) and covariate-adjusted (hazard ratio = 1.23, 95 % CI:1.06–1.41) models; and was associated with ESKD and albuminuria progression. The relationship between DAI and significant eGFR decline was attenuated after accounting for PEDF, which explained 53.6 % of the indirect effect of DAI on significant eGFR decline.

Conclusions

Elevated DAI and its associated PEDF may serve as useful indicators for kidney function decline in T2DM.

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2型糖尿病患者色素上皮衍生因子与功能性肥胖指数与肾脏损害的关联——一项为期11年的SMART2D队列研究随访

目的：本研究旨在探讨亚洲多民族2型糖尿病（T2DM）患者新的功能失调肥胖指数（DAI）与肾脏损害的关系，以及色素上皮衍生因子（PEDF）的中介作用。方法：对T2DM成人进行长达10.5年的随访分析（n = 1611）。DAI采用性别特异性公式计算。基线血浆PEDF水平用免疫分析法定量。糖尿病肾病（DKD）被定义为存在慢性肾脏疾病和/或蛋白尿。纵向结果包括估计肾小球滤过率较基线下降≥40% （eGFR显著下降）、蛋白尿进展和终末期肾病（ESKD）。结果：基线DAI与肾脏参数和DKD横断面相关，并表现出增强的辨别能力。DAI与PEDF相关（rho = 0.324， P）结论：DAI升高及其相关PEDF可能是T2DM患者肾功能下降的有用指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.