Optimal Obesity- and Lipid-Related Indices for Predicting Metabolic Syndrome in Chronic Kidney Disease Patients with and without Type 2 Diabetes Mellitus in China

• Published in: Nutrients 2022-03, Vol.14 (7), p.1334
• Main Authors: Li, Hangtian, Wang, Qian, Ke, Jianghua, Lin, Wenwen, Luo, Yayong, Yao, Jin, Zhang, Weiguang, Zhang, Li, Duan, Shuwei, Dong, Zheyi, Chen, Xiangmei
• Format: Article
• Language: English
• Subjects: Adipose tissue; Adiposity; Adolescent; Adult; Blood pressure; Body mass; Body Mass Index; Body size; Cardiovascular disease; China - epidemiology; Cholesterol; chronic kidney disease; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Dialysis; Fasting; Female; Glucose; High density lipoprotein; Humans; Hyperglycemia; Hypertension; Kidney diseases; Kidneys; lipid accumulation product; Lipids; Lipoproteins; Male; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - diagnosis; Mortality; Obesity; Obesity - complications; Obesity, Abdominal - complications; Patients; Peritoneal dialysis; Regression analysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; ROC Curve; Sensitivity; Statistical analysis; type 2 diabetes mellitus; visceral adiposity index; visceral fat area; Waist Circumference
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14071334

Existing obesity- and lipid-related indices are inconsistent with metabolic syndrome (MetS) in chronic kidney disease (CKD) patients. We compared seven indicators, including waist circumference (WC), body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), visceral adiposity index (VAI), Chinese VAI and lipid accumulation product (LAP), to evaluate their ability to predict MetS in CKD patients with and without Type 2 diabetes mellitus (T2DM) under various criteria. Multivariate logistic regression analysis was used to investigate the independent associations between the indices and metabolic syndrome among 547 non-dialysis CKD patients, aged ≥18 years. The predictive power of these indices was assessed using receiver operating characteristic (ROC) curve analysis. After adjusting for potential confounders, the correlation between VAI and MetS was strongest based on the optimal cut-off value of 1.51 (sensitivity 86.84%, specificity 91.18%) and 2.35 (sensitivity 83.54%, specificity 86.08%), with OR values of 40.585 (8.683-189.695) and 5.076 (1.247-20.657) for males and females with CKD and T2DM. In CKD patients without T2DM, based on the optimal cut-off values of 1.806 (sensitivity 98.11%, specificity 72.73%) and 3.11 (sensitivity 84.62%, specificity 83.82%), the OR values were 7.514 (3.757-15.027) and 3.008 (1.789-5.056) for males and females, respectively. The area under ROC curve (AUC) and Youden index of VAI were the highest among the seven indexes, indicating its superiority in predicting MetS in both male and female CKD patients, especially those with T2DM.