Kidney Week

Abstract: SA-PO0489

Body Adiposity and Albuminuria in Patients with Type 2 Diabetes Without Obesity: Is There an Association?

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Telez Cuatlatl, Alan, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Alan Telez Cuatlatl, DrMed

• Alarcón Salinas, José Roberto, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

José Roberto Alarcón Salinas, DrMed

• Zavala Miranda, Fernanda, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Fernanda Zavala Miranda, MS, MSc

• García Ulloa, Cristina, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Cristina García Ulloa, MD

• Hernandez-Jimenez, Sergio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Sergio Hernandez-Jimenez, MD

• Ramirez-Sandoval, Juan Carlos, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico

Juan Carlos Ramirez-Sandoval, MD, PhD

Background

Revised clinical obesity definitions suggest that excess adiposity may increase kidney damage risk independently of body mass index (BMI) and comorbidities like type 2 diabetes (T2D). Our aim was to evaluate the association between adiposity (assessed via bioelectrical impedance) and albuminuria in adults with T2D, particularly those not meeting BMI criteria for obesity.

Methods

This cross-sectional study included 342 T2D participants from a diabetes care program. Adiposity was defined by World Health Organization standards (body fat percentage [BF%] >25% in men; >35% in women). Increased albuminuria was defined as a urinary albumin-creatinine ratio (UACR) ≥30 mg/g.

Results

Participants' mean age was 56 ± 11 years and 54% were female. Obesity prevalence was 48% by BMI (> 30 kg/m²) and 85% by BF%. Notably, 39% of participants had excess adiposity despite a non-obese BMI. In this group, albuminuria prevalence (20%) was comparable to those with BMI-defined obesity (26%, P = 0.22). Albuminuria prevalence was consistent across BMI categories (<25, 25–29.9, and ≥30 kg/m²: 27%, 22%, and 26%, respectively) and adiposity status (23% with vs. 32% without, P = 0.21). Multivariable analysis showed that HbA1c >7% (OR 2.8, 95% CI 1.6–4.8) and mean arterial pressure (OR 1.5, 95% CI 1.2–2.0) were independently associated with albuminuria (P<0.001). Conversely, neither BMI nor BF% showed an association with albuminuria after adjusting for age, diabetes duration, treatment, or other confounders.

Conclusion

Excess adiposity without BMI-defined obesity is common in T2D; however, body fat composition did not impact albuminuria. These findings support universal albuminuria screening in T2D, regardless of BMI or adiposity status.