Association between a diabetes-predictive index and diabetes-related kidney disease in U.S. adults: A cross-sectional study

Objective

This study aimed to investigate the association between Zhejiang University (ZJU) index and diabetic kidney disease (DKD) in U.S. adults.

Methods

We selected 13,549 U.S. adults aged 20 years or older from the National Health and Nutrition Examination Survey 2009–2020. The ZJU index is a composite score calculated by summing fasting plasma glucose, body mass index, triglycerides, and three times the alanine aminotransferase to aspartate aminotransferase ratio, with an additional 2 points for female subjects. DKD was defined by the presence of confirmed diabetes combined with a urine albumin-to-creatinine ratio ≥ 30 mg/g or an estimated glomerular filtration rate < 60 mL/min/1.73 m². We employed weighted multivariable logistic regression and sensitivity analyses to investigate the association between the ZJU index and DKD.

Results

The ZJU index is positively associated with DKD in U.S. adults. In adjusted model, the ZJU index showed a positive association with DKD (OR: 1.13, 95 % CI: 1.10, 1.16).

Conclusions

The findings suggest ZJU index's potential utility as a candidate metabolic marker associated with DKD. The ZJU index may serve as an auxiliary biomarker for DKD screening. However, due to the cross-sectional nature of the study, we cannot infer causal relationship between ZJU index and DKD.