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Abstract: SA-PO549

Relationship Between Waist Circumference and Renal Function Decline Rate

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Author

  • Araki, Makoto, Suwa Central Hospital, Chino, NAGANO, Japan
Background

As hyperinsulinemia correction is one of the renal protective effects of SGLT2 inhibitors, we hypothesized that hyperinsulinemia-insulin resistance deteriorates renal function. Therefore, we investigated the relationship between waist circumference, a marker of visceral fat and an indicator of insulin resistance, and renal function decline rate.

Methods

In this single-institutional observational study in Japan, subjects were selected from those who underwent creatinine and waist circumference measurements at annual health examinations from 2008 to 2018. Subjects had undergone examinations for ≥2 years; their estimated glomerular filtration rate (eGFR) in the first year was > 60 ml/min/1.73 m2. The subjects were divided into two groups: visceral adiposity group (VCA group) and control group, by the initial abdominal circumference based on diagnostic criteria for metabolic syndrome in Japan. We adjusted for the following baseline variables: model 1: age, sex, observation period, and initial eGFR; model 2: model 1 + systolic blood pressure, low-density lipoprotein cholesterol, and hemoglobin A1C during the observation period. We evaluated both groups by time-to-event analysis for 30% eGFR decline.

Results

Totally, 8390 subjects (56.4% men, mean age: 47.7 years, mean observation period: 1751.1 days) met the criteria. The mean waist circumference was 77.0 cm in the control group and 92.3 cm in the VCA group. When adjusted using propensity score, 2127 (model 1) and 1804 (model 2) subjects in each group were extracted. In the time-to-event analysis for 30% eGFR decline, there was a significantly difference in model 1 (hazard ratio, 2.73 [95% CI, 1.51-4.94]; P<0.001), but not model 2 (hazard ratio, 1.78 [95% CI, 0.96-3.29]; P=0.06).

Conclusion

Excess visceral fat is associated with decreased renal function. However, after adjustment for hypertension, lipids, and glucose intolerance, this study failed to establish a relationship between hyperinsulinemia-insulin resistance and decreased renal function.