Contribution of obesity to renal lesion in patients with type 2 diabetes mellitus


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Abstract

Aim. To study of the contribution of obesity to renal lesion in patients with type 2 diabetes mellitus (T2DM).
Subects and methods. One hundred and fifty-four patients (62 males and 92 females) with T2DM (mean age 58±8 years) were examined. The study excluded patients with significant stages of diabetic nephropathy (glomerular filtration rate (GFR) < 60 ml/min; proteinuria more than 2 g/day). Anthropometric indicators, such as body mass index (BMI), were estimated. The serum levels of creatinine, uric acid (UA), lipid composition, and the adipose tissue hormones leptin and adiponectin were measured. Renal lesion was evaluated from GFR and urine albumin excretion level. Groups of patients with a less and more than 5-year history and subgroups of a MBI of less and more than 30 kg/m2 were identified.
Results. In patients with a more than 5-year history of T2DM, the detection rate of microalbuminuria and proteinuria increased as obesity progressed. This regularity was not found in those with a less than 5-year history of T2DM. Diabetic patients with a BMI of l 30 kg/m2 were more frequently found to have intrarenal hemodynamic disorders (hyperfiltration) elevated blood pressure, increased UA, and decreased high-density lipoproteins, as compared with those with a BMI of < 30 kg/m2.
With a higher BMI, leptin levels increased; its highest values were found in a group of patients with proteinuria. Hypoadiponectinemia was detected in most patients with T2DM. Adiponectin was decreased in early-stage nephropathy; its increase was further increased.
Conclusion. There was a greater prevalence of renal lesion in obese (BMI l 30 kg/m2) patients with a more than 5-year history of T2DM than in non-obese patients. Obesity has an impact on renal function due to its hemodynamic, metabolic, and hormonal effects.

About the authors

I M Kutyrina

I. M. Sechenov Moscow Medical Academy

Клиника нефрологии, внутренних и профессиональных заболеваний им. Е. М. Тареева, кафедра нефрологии и гемодиализа ФППОВд-р мед. наук, проф; ММА им. И. М. Сеченова; I. M. Sechenov Moscow Medical Academy

S A Savelyeva

I. M. Sechenov Moscow Medical Academy

Email: sa.saveleva@gmail.com
Клиника нефрологии, внутренних и профессиональных заболеваний им. Е. М. Тареева, кафедра нефрологии и гемодиализа ФППОВаспирант; ММА им. И. М. Сеченова; I. M. Sechenov Moscow Medical Academy

A A Kryachkova

I. M. Sechenov Moscow Medical Academy

Клиника нефрологии, внутренних и профессиональных заболеваний им. Е. М. Тареева, кафедра нефрологии и гемодиализа ФППОВнауч. сотр; ММА им. И. М. Сеченова; I. M. Sechenov Moscow Medical Academy

M V Shestakova

Endocrinology Research Center, Russian Agency for Medical Technologies, Moscow

Клиника нефрологии, внутренних и профессиональных заболеваний им. Е. М. Тареева, кафедра нефрологии и гемодиализа ФППОВд-р мед. наук, проф., дир., Институт диабета; ФГУ Эндокринологический научный центр Росмедтехнологий; Endocrinology Research Center, Russian Agency for Medical Technologies, Moscow

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