Elevated waist-to-hip ratio, as an abdominal obesity index, predicts the risk of diabetic kidney injury

doi:10.4239/wjd.v16.i4.101384

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Apr 15, 2025 (publication date) through Feb 28, 2025

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Diabetes. Apr 15, 2025; 16(4): 101384
Published online Apr 15, 2025. doi: 10.4239/wjd.v16.i4.101384

Table 1 Overall characteristics of the cohort, n (%)

Variables	Patients
Sex	Male	649 (65.49)
Sex	Female	342 (34.51)
Age (years)	18-55	991 (71.14)
Age (years)	> 55	286 (28.86)
Blood pressure	Normal	708 (71.59)
Blood pressure	High	281 (28.41)
BMI	BMI > 24	551 (55.71)
BMI	BMI ≤ 24	438 (44.29)
Duration of T2DM	0-5 year	575 (58.38)
Duration of T2DM	> 5 years	410 (41.62)
Drinker	Yes	450 (47.42)
Drinker	No	499 (52.58)
Smoker	Yes	307 (31.17)
Smoker	No	678 (68.83)

BMI: Body mass index; T2DM: Type 2 diabetic mellitus.

Table 2 Basic characteristics of the patients

	Con¹	NAU²	MAU³	CAU
TC (mmol/L)	4.73 (4.15-5.44)	4.64 (3.94-5.32)	4.95 (4.18-5.69)	4.71 (3.84-6.42)
TG (mmol/L)	0.99 (0.74-1.40)	1.58 (1.11-2.32)¹	1.79 (1.17-2.52)¹	2.31 (1.79-3.09)¹^,²^,³
LDL-C (mmol/L)	2.84 (2.40-3.57)	2.87 (2.25-3.53)	3.04 (2.28-3.56)	2.50 (1.81-4.21)
HDL-C (mmol/L)	1.39 (1.16-1.58)	0.99 (0.84-1.18)¹	1.05 (0.89-1.21)¹	0.95 (0.88-1.21)¹
non-HDL-C (mmol/L)	3.30 (2.73-3.99)	3.65 (2.92-4.24)¹	3.87 (3.02-4.57)¹	3.89 (2.77-5.12)¹
AIP	-0.16 (-0.32-0.06)	0.21 (0.02-0.39)¹	0.22 (-0.01-0.41)¹	0.33 (0.22-0.45)¹^,²^,³
ALB (g/L)	44.05 (42.40-45.58)	41.8 (39-44.63)¹	42.4 (39.3-45.7)¹	39.3 (36-43)¹^,²^,³
γ-GGT (IU/L)	18 (14-30)	31 (20-50)¹	33 (20-54)¹	32 (20-46)¹
UA (μmol/L)	286.5 (238.75-349)	323 (273-388)¹	333.5 (271.75-388.25)¹	359 (317-438)¹^,²
Creatinine (μmol/L)	58 (51-69)	67 (60-73)¹	67 (59-74)¹	72 (62-78)¹
BUN (mmol/L)	4.98 (4.11-5.63)	5.14 (4.26-6.09)	5.37 (4.44-6.47)¹	5.9 (4.98-6.87)¹^,²
ALT	18 (13-26)	25 (17-39)¹	23 (16-40.75)¹	21 (15-31)
AST	19.5 (17-23)	19 (15-25.25)	20 (16-26)	20 (15-25)

¹P < 0.05 represented as significant vs healthy controls group.

²P < 0.05 represented as significant vs normal albuminuria group.

³P < 0.05 represented as significant vs microalbuminuria group.

Con: Healthy controls; NAU: Normal albuminuria; MAU: Microalbuminuria; CAU: Clinical proteinuria; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; non-HDL-C: Non-high-density lipoprotein cholesterol; AIP: The data of log (triglyceride/high-density lipoprotein cholesterol); ALB: Albumin; γ-GGT: Gamma-glutamyl transferase; ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; UA: Urine acid.

Table 3 Factors associated with kidney injury in patients with type 2 diabetic mellitus in univariable logistic regression analysis

Variables	OR (95%CI)	P value
WHR	251.09 (15.31-4119.00)	< 0.001^a
VSR	1.237 (0.408-3.753)	0.707
TC	1.174 (1.048-1.314)	0.005^a
TG	1.066 (0.998-1.140)	0.057
HDL-C	2.063 (1.141-3.728)	0.016^a
LDL-C	1.076 (0.926-1.250)	0.34
non-HDL-C	1.143 (1.024-1.277)	0.018^a
AIP	1.481 (0.916-2.394)	0.109
BUN	1.03 (0.985-1.078)	0.197
Creatinine	1.01 (1-1.02)	0.044^a
UA	1.002 (1-1.004)	0.03^a

^aP < 0.05.

OR: Odds ratio; CI: Confidence interval; WHR: Waist-to-hip ratio; VSR: Subcutaneous fat area ratio; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; non-HDL-C: Non-high-density lipoprotein cholesterol; AIP: The data of log (triglyceride/high-density lipoprotein cholesterol); BUN: Blood urea nitrogen; UA: Urine acid.

Table 4 Factors associated with kidney injury in patients with type 2 diabetic mellitus in stepwise multivariable logistic regression analysis

Variables	OR (95%CI)	P value
Model 1
WHR	1.113 (0.56-1.67)	< 0.001^a
Model 2
WHR	1.349 (0.785-1.913)	< 0.001^a
HDL-C	0.225 (0.098-0.351)	0.001^a
Model 3
WHR	1.309 (0.746-1.872)	< 0.001^a
HDL-C	0.21 (0.083-0.336)	0.001^a
TC	0.03 (0.007-0.052)	0.011^a
Model 4
WHR	1.299 (0.737-1.861)	< 0.001^a
HDL-C	0.213 (0.087-0.34)	0.001^a
TC	0.029 (0.007-0.052)	0.011^a
Creatinine	0.002 (0-0.004)	0.038^a

^aP < 0.05.

Model 1: Total cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, creatinine, and urine acid were excluded; Model 2: Total cholesterol, non-high-density lipoprotein cholesterol, creatinine, and urine acid were excluded; Model 3: Non-high-density lipoprotein cholesterol, creatinine, and urine acid were excluded; Model 4: Non-high-density lipoprotein cholesterol and urine acid were excluded; OR: Odds ratio; CI: Confidence interval; WHR: Waist-to-hip ratio; HDL-C: High-density lipoprotein cholesterol; TC: Total cholesterol.

Citation: Lin DN, Li D, Peng MM, Yang H, Lin ZZ, Ye EL, Chen WT, Zhou MX, Huang XE, Lu XM. Elevated waist-to-hip ratio, as an abdominal obesity index, predicts the risk of diabetic kidney injury. World J Diabetes 2025; 16(4): 101384
URL: https://www.wjgnet.com/1948-9358/full/v16/i4/101384.htm
DOI: https://dx.doi.org/10.4239/wjd.v16.i4.101384