Obesity - a risk factor of renal pathology in patients with type 2 diabetes mellitus
Abstract
Aim.
To study association between obesity and renal pathology in patients with type 2 diabetes mellitus (DM2).
Materials and methods.
The study included 106 patients with CD2 (41 men and 65 women) of mean age 60.0?7.0 years. Exclusion criteria wereduration of DM2 less than 5 years and manifest diabetic nephropathy (DN) (glomerular filtraton rate (GFR) below 60 ml/min/m2, albuminuria over2 g/24 hr). Anthropometric parameters measured included body mass index (BMI). Serum creatinine, uric acid, lipid spectrum, hormones of adiposetissue (leptin and adiponectin) were determined. Severity of renal pathology was estimated from GF and albumin excretion in urine. The patients were categorized into 2 groups: with obesity (BMI>=30 kg/m2) and without it (BMI<30 kg/m2).
Results.
Occurrence of microalbuminuria and proteinuria increased with the degree of obesity (p<0.05). Patients with BMI>=30 kg/m2 more frequently presented with disturbed intrarenal dynamics (hyperfiltration), elevated arterial pressure, and reduced LVLD level than patients with BMI<30 kg/m2. Leptin levels increased with BMI. All patients with proteinuria showed hyperleptinemia. 89% of the DM2 patients had hypoadiponectinemia. Adiponectin levels dropped in DN at the stage of microalbuminuria compared with control. Patients with DN at the stage of proteinuria exhibiteda rise in adiponectin.
Conclusion.
Patients with DM2 and obesity (BMI>=30 kg/m2) more frequently develop renal pathology than in the absence of obesity. It suggests anindependent role of obesity in the development of DN in addition to specific mechanisms of renal pathology intrinsic in DM. This effect of obesity ismediated through the enhancement of hemodynamic and metabolic disorders coupled to the negative influence of adipose tissue hormones.
To study association between obesity and renal pathology in patients with type 2 diabetes mellitus (DM2).
Materials and methods.
The study included 106 patients with CD2 (41 men and 65 women) of mean age 60.0?7.0 years. Exclusion criteria wereduration of DM2 less than 5 years and manifest diabetic nephropathy (DN) (glomerular filtraton rate (GFR) below 60 ml/min/m2, albuminuria over2 g/24 hr). Anthropometric parameters measured included body mass index (BMI). Serum creatinine, uric acid, lipid spectrum, hormones of adiposetissue (leptin and adiponectin) were determined. Severity of renal pathology was estimated from GF and albumin excretion in urine. The patients were categorized into 2 groups: with obesity (BMI>=30 kg/m2) and without it (BMI<30 kg/m2).
Results.
Occurrence of microalbuminuria and proteinuria increased with the degree of obesity (p<0.05). Patients with BMI>=30 kg/m2 more frequently presented with disturbed intrarenal dynamics (hyperfiltration), elevated arterial pressure, and reduced LVLD level than patients with BMI<30 kg/m2. Leptin levels increased with BMI. All patients with proteinuria showed hyperleptinemia. 89% of the DM2 patients had hypoadiponectinemia. Adiponectin levels dropped in DN at the stage of microalbuminuria compared with control. Patients with DN at the stage of proteinuria exhibiteda rise in adiponectin.
Conclusion.
Patients with DM2 and obesity (BMI>=30 kg/m2) more frequently develop renal pathology than in the absence of obesity. It suggests anindependent role of obesity in the development of DN in addition to specific mechanisms of renal pathology intrinsic in DM. This effect of obesity ismediated through the enhancement of hemodynamic and metabolic disorders coupled to the negative influence of adipose tissue hormones.
About the Authors
Svetlana Alekseevna Savel'eva
I.M. Sechenov Moscow Medical Academy, Moscow
Alexandra Alexandrovna Kryachkova
I.M. Sechenov Moscow Medical Academy, Moscow
Kseniya Olegovna Kurumova
Endocrinology Research Centre, Moscow
Minara Shamkhalovna Shamkhalova
Endocrinology Research Centre, Moscow
Irina Mikhailovna Kutyrina
I.M. Sechenov Moscow Medical Academy, Moscow
Marina Vladimirovna Shestakova
Endocrinology Research Centre, Moscow
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Review
For citations:
Savel'eva S.A., Kryachkova A.A., Kurumova K.O., Shamkhalova M.Sh., Kutyrina I.M., Shestakova M.V. Obesity - a risk factor of renal pathology in patients with type 2 diabetes mellitus. Diabetes mellitus. 2010;13(2):45-49. (In Russ.)
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