Objective

The aim of this study was to investigate the relationship between weight-adjusted-waist index (WWI) and diabetic kidney disease in individuals afflicted with type 2 diabetes.

Methods

Comprehensive data were ascertained from the National Health and Nutrition Examination Survey in 2013–March 2020. Weighted univariate, multivariate logistic regression models, subgroup analyses and tests for interaction were performed. Additionally, we employed smooth curve fitting to assess linear correlations and the threshold effects were calculated by applying a binary linear regression model. Breakpoints are identified by a model with maximum likelihood ratio and a two-step recursive approach. Receiver operating characteristic curve (ROC) along with the area under the curve (AUC) value predict the capability of WWI and body mass index for diabetic kidney disease.

Results

A total of 10,661 individuals diagnosed with type 2 diabetes were included, and the overall prevalence of diabetic kidney disease was 20.74%. WWI exhibited a positive correlation with the likelihood of diabetic kidney disease in type 2 diabetes patients (OR: 1.17, 95% CI: 1.03–1.33). The results of subgroup analysis showed significant interaction for gender (P < 0.05). Among female patients, U-shaped correlations were observed with a breakpoint at 11.48. Additionally, weight-adjusted waist index (AUC = 0.664) proved to be a more effective predictor of diabetic kidney disease compared to body mass index (AUC = 0.555).

Conclusion

In patients with type 2 diabetes, increased weight-adjusted-waist index is implicated with an increased risk of diabetic kidney disease. WWI can be used as a new anthropometric index to predict diabetic kidney disease, and its predictive ability is stronger than body mass index.

中文翻译：

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体重调整腰围指数与 2 型糖尿病肾病的关联

客观的

本研究的目的是调查 2 型糖尿病患者的体重调整腰围指数 (WWI) 与糖尿病肾病之间的关系。

方法

综合数据来源于2013年至2020年3月全国健康与营养状况调查。进行了加权单变量、多变量逻辑回归模型、亚组分析和交互作用检验。此外，我们采用平滑曲线拟合来评估线性相关性，并通过应用二元线性回归模型计算阈值效应。断点是通过具有最大似然比的模型和两步递归方法来识别的。受试者工作特征曲线 (ROC) 和曲线下面积 (AUC) 值可预测 WWI 和体重指数对糖尿病肾病的影响。

结果

共纳入10661名2型糖尿病患者，糖尿病肾病总体患病率为20.74%。WWI 与 2 型糖尿病患者患糖尿病肾病的可能性呈正相关（OR：1.17，95% CI：1.03-1.33）。亚组分析结果显示性别间存在显着交互作用（P <0.05）。在女性患者中，观察到 U 形相关性，断点为 11.48。此外，与体重指数（AUC = 0.555）相比，体重调整腰围指数（AUC = 0.664）被证明是糖尿病肾病更有效的预测指标。

结论

在 2 型糖尿病患者中，体重调整腰围指数增加与糖尿病肾病风险增加有关。WWI可作为预测糖尿病肾病的新人体测量指标，其预测能力强于体重指数。