Abstract
This novel longitudinal study investigated the association of the new dysfunctional adiposity index (DAI) with kidney impairment in multi-ethnic Asians with type 2 diabetes mellitus (T2DM), and the mediation effect of pigment epithelium-derived factor (PEDF). T2DM adults followed for up to 10.5years were analyzed (n=1611). DAI was calculated using a sex-specific formula. Baseline plasma PEDF levels were quantified using immunoassay. Diabetic kidney disease (DKD) was defined as presence of chronic kidney disease and/or albuminuria. The longitudinal outcomes included ≥40% decline in estimated glomerular filtration rate from baseline (significant eGFR decline), albuminuria progression, and end-stage kidney disease (ESKD). Baseline DAI was associated with kidney parameters and DKD cross-sectionally, and showed increased discrimination ability. DAI was correlated with PEDF (rho=0.324, P<0.001). Additionally, DAI predicted significant eGFR decline (35.8% prevalence) in the unadjusted (hazard ratio=1.49, 95% CI:1.31-1.70) and covariate-adjusted (hazard ratio=1.23, 95% CI:1.06-1.41) models; and was associated with ESKD and albuminuria progression. The relationship between DAI and significant eGFR decline was attenuated after accounting for PEDF, which explained 53.6% of the indirect effect of DAI on significant eGFR decline. Elevated DAI and its associated PEDF may serve as useful indicators for kidney function decline in T2DM.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call