Background: The incidence of chronic kidney disease among patients with diabetes mellitus (DM) remains a global concern. Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus. However, no previous meta-analysis has assessed the effects of body mass index (BMI) on adverse kidney events in patients with DM.

Aim: To determine the impact of BMI on adverse kidney events in patients with DM.

Methods: A systematic literature search was performed on the PubMed, ISI Web of Science, Scopus, Ovid, Google Scholar, EMBASE, and BMJ databases. We included trials with the following characteristics: (1) Type of study: Prospective, retrospective, randomized, and non-randomized in design; (2) participants: Restricted to patients with DM aged ≥ 18 years; (3) intervention: No intervention; and (4) kidney adverse events: Onset of diabetic kidney disease [estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m and/or microalbuminuria value of ≥ 30 mg/g Cr], serum creatinine increase of more than double the baseline or end-stage renal disease (eGFR < 15 mL/min/1.73 m or dialysis), or death.

Results: Overall, 11 studies involving 801 patients with DM were included. High BMI (≥ 25 kg/m) was significantly associated with higher blood pressure (BP) [systolic BP by 0.20, 95% confidence interval (CI): 0.15-0.25, < 0.00001; diastolic BP by 0.21 mmHg, 95%CI: 0.04-0.37, = 0.010], serum albumin, triglycerides [standard mean difference (SMD) = 0.35, 95%CI: 0.29-0.41, < 0.00001], low-density lipoprotein (SMD = 0.12, 95%CI: 0.04-0.20, = 0.030), and lower high-density lipoprotein (SMD = -0.36, 95%CI: -0.51 to -0.21, < 0.00001) in patients with DM compared with those with low BMIs (< 25 kg/m). Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI (RR: 1.22, 95%CI: 1.01-1.43, = 0.036).

Conclusion: The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841950PMC
http://dx.doi.org/10.12998/wjcc.v12.i3.538DOI Listing

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