Obesity and albuminuria among adults with type 2 diabetes

OBJECTIVE — To determine the association between obesity measures and albuminuria in adults with type 2 diabetes. RESEARCH DESIGN AND METHODS — In the Look AHEAD (Action for Health in Diabetes) Study, BMI and waist circumference were measured among 4,985 participants while total percent body fat was measured by whole-body DEXA scans among 1,351 participants. Odds of albuminuria by quartiles of BMI, waist circumference, and percent total body fat were calculated using logistic regression analysis while adjusting for covariates. RESULTS — The highest quartile of BMI (odds ratio [OR] 1.72 [95 % CI 1.40–2.11]) and waist circumference (OR 1.75 [95 % CI 1.42–2.15]) was significantly associated with albumin-uria compared with the lowest quartile after adjustment for covariates. No associations were noted between quartiles of percent total body fat and albuminuria in any model. CONCLUSIONS — Increased BMI and abdominal obesity are associated with albuminuria in overweight and obese adults with type 2 diabetes. Diabetes Care 32:851–853, 2009 D espite substantial improvements inblood pressure and glucose control,2 % of adults develop microalbu-minuria per year after type 2 diabetes di-agnosis (1). Lifestyle factors remain an integral component of cardiovascular risk reduction, yet treatment and pre-vention of albuminuria (micro- or mac-roalbuminuria) have primarily focused on pharmacologic agents, specifically those which block the renin angiotensin system. This study examined the asso-ciation between measures of obesity and albuminuria among adults who partici-pated in the Look AHEAD (Action for Health in Diabetes) Study. We hypoth-esized that obesity is positively associ-ated with albuminuria