Abstract: SA-PO0903
Albuminuria, Not BMI, Defines Clinical Obesity Severity: ABCD Staging Uncovers Hidden Kidney Damage in Type 2 Diabetes
Session Information
- Health Maintenance, Nutrition, and Metabolism
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Dunaway, Tiffany Amber, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Inacio, Maithe Caroline, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Rodríguez Ibarra, Kenya Y., Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Treviño Carrión, Daniela Janeth, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Contreras Jaramillo, Karol Valentina, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Garcia Carrera, Keila Maria, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Olivo, Mara Cecilia, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Lavalle González, Fernando Javier, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
- Rizo Topete, Lilia Maria, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, N.L., Mexico
Background
The Adiposity-Based Chronic Disease (ABCD, AACE 2025) classification incorporates adiposity-related complications as diagnostic criteria for obesity, unlike BMI-based models. In type 2 diabetes (T2DM), albuminuria is an early marker of renal damage and this study aimed to determine the prevalence of albuminuria and its correlation with BMI, glomerular filtration rate (GFR), and ABCD stage in a cohort of patients with T2DM.
Methods
Cross-sectional study of 57 adults with T2DM at first contact with internal medicine at Hospital Universitario "Dr. José Eleuterio González," Monterrey, México. Albuminuria was graded A1-A3 per KDIGO criteria. eGFR was calculated using CKD-EPI. ABCD stage was assigned per AACE 2025 (stage 1: no complications; 2: mild-moderate; 3: severe). Obesity was defined as BMI ≥30 kg/m2. Spearman correlations, Mann-Whitney U, Kruskal-Wallis, and Fisher's exact tests were applied.
Results
Mean age 63±11 years, 47% female, BMI 28.7±6.4 kg/m2, eGFR 57.6±15.5 mL/min/1.73m2, T2DM duration 17±11 years. At first medical contact, 94.7% had albuminuria (grade A1: 28.1%; grade A2: 45.6%; grade A3: 24.6%) and 87.5% met ABCD Stage ≥2 criteria, with no prior CKD diagnosis. Paradoxically, BMI inversely correlated with albuminuria grade (rs=−0.46, p<0.001) and ABCD stage (rs=−0.31, p=0.019). Median urinary albumin was 133-foldhigher in normal-BMI than in class I obesity patients (2,000 vs 15 mg/g; p=0.016). Non-obese patients had higher prevalence of ABCD Stage ≥2 than obese patients (97.1% vs 71.4%; p=0.016). BMI remained an independent inverse predictor of albuminuria after adjusting for age, T2DM duration, and hypertension (β=−0.12, 95%CI: −0.20 to −0.04; p=0.003; adj.R2=0.17). Mean BMI decreased across ABCD stages: Stage 1 (34.9±7.6), Stage 2 (29.0±6.5), Stage 3 (27.0±4.9 kg/m2; p=0.028).
Conclusion
In first-contact T2DM patients, albuminuria severity and ABCD clinical obesity stage are inversely associated with BMI, independent of diabetes duration and hypertension. Non-obese patients harbored the most severe renal damage, undetected prior to this evaluation. These findings challenge BMI-centric risk stratification and support albuminuria grading combined with ABCD staging as essential tools for early identification of clinical obesity-related renal damage in T2DM, regardless of body weight.