Correlation Between CVAI And 24-hour Urine Microalbumin Creatinine Ratio In Type 2 Diabetic Patients

Background: Obesity is a risk factor for cardiovascular disease,metabolic disease,non-alcoholic fatty liver disease,polycystic ovary syndrome,female infertility,male hypogonadism,sleep apnea syndrome,asthma,airway hyperresponsiveness,osteoarthritis,stress urinary incontinence,gastroesophageal reflux disease,depression,and many other diseases.Besides,the obesity epidemic has spread to nephrology and obesity has been identified as an independent risk factor for chronic kidney disease.It is well known that changes in proteinuria are strongly associated with the progression of chronic kidney disease and that the incidence of chronic renal failure is increasing each year in China,with all-cause mortality due to it rising each year.The correlation between central obesity and obesity measures such as BMI and proteinuria is still controversial.Studies have concluded that MES due to obesity is an important factor in renal disease,with no significant correlation with BMI and WC.There is considerable evidence that visceral adipose tissue,rather than subcutaneous adipose tissue,plays a malignant role in metabolic disease.However,WC contains both subcutaneous and visceral fat,and most current studies in China suggest that the Chinese Visceral Adiposity Index CVAI is not only closely related to the visceral fat area but also reflects the metabolic characteristics of the body.OBJECTIVE: This study aims to investigate the correlation between CVAI and24-hour urinary microalbumin creatinine ratio in patients with combined type 2 diabetesMETHODS: The study was a retrospective cross-sectional study in which diabetic patients admitted to the Department of Endocrinology of Shenzhen Second People’s Hospital from February 2019 to September 2019 were collected after excluding type 1 diabetes,special types of diabetes,BMI <18.5 kg/m2,severe infections,severe liver and kidney insufficiency(transaminases higher than 3 times normal,e GFR <30 ml/(min-The final 185 cases(104 males and 81 females)were included after the inclusion of those with missing data.The relationship between each variable and the 24-hour urinary microalbumin creatinine ratio was analyzed univariately,and further multiple regression analysis was performed on the continuous variable CVAI and the 24-hour urinary protein creatinine ratio.Curve fitting was used to clarify whether the relationship between CVAI and 24-hour urinary microalbumin creatinine ratio was linear in type 2 diabetic patients,and further threshold saturation effect analysis was performed to define the threshold point at which CVAI significantly increased the 24-hour urinary microalbumin creatinine ratio.RESULTS: The relationship between CVAI and 24-hour urinary microalbumin creatinine ratio was further analyzed using multiple linear regression equations.The relationship between CVAI and 24-hour urinary microalbumin creatinine ratio increased by 35.1 mg/g for every 10 increase in CVAI in the unadjusted variable model,with a 95% confidence interval of 12.2-58.1 mg/g,P< After adjusting for sex and age,the 24-hour urinary microalbumin creatinine ratio increased by 35.1mg/g for every 10 increase in CVAI,with a 95% confidence interval of 12.21-58.1mg/g,P<0.01;Model II was adjusted for duration of diabetes,duration of obesity,systolic blood pressure,diastolic blood pressure,use of lipid-lowering drugs,dyslipidemia,use of insulin In model II,after adjusting for the duration of diabetes,obesity,systolic blood pressure,diastolic blood pressure,use of lipid-lowering drugs,dyslipidemia,use of insulin,Hb A1c%,free triiodothyronine,free tetraiodothyronine,e GFR,uric acid,MES,and hsCRP,we showed that for every 10 increase in CVAI,the 24-hour urinary microalbumin creatinine ratio increased by 49.7 mg/g,with a 95% confidence interval of 18.5-80.9,P<0.01.We also performed a curve fitting analysis based on a threshold Saturation effect analysis to define the threshold point showed a linear relationship between CVAI and the 24-hour urinary microalbumin creatinine ratio after adjustment for model I with a p-value <0.01,while adjustment for model II showed no statistically significant correlation between CVAI and 24-hour urinary microalbumin creatinine ratio when CVAI was <88.When CVAI was ≥88,the correlation between CVAI and 24-hour urinary microalbumin creatinine ratio was still significantly positive after adjustment for Model II.For every 10 increase in CVAI,the 24-hour urinary microalbumin creatinine ratio increased by 60.6mg/g,with a 95% confidence interval of 27.6-93.6mg/g,p<0.001Conclusion: As shown in our study,CVAI was positively correlated with 24-hour urinary microalbumin creatinine ratio in patients with T2 DM,which can more accurately reflect the risk of chronic kidney disease in patients with T2 DM,so that early intervention can be made to minimize the occurrence of end-stage chronic kidney disease.