Obesity and Albuminuria Among Adults With Type 2 Diabetes

Obesity and Albuminuria Among Adults With Type 2 Diabetes The Look AHEAD (Action for Health in Diabetes) Study Holly Kramer , MD, MPH 1 , David Reboussin , PHD 2 , Alain G. Bertoni , MD 3 , Santica Marcovina , PHD, SCD 4 , Edward Lipkin , MD, PHD 5 , Frank L. Greenway III , MD 6 , Frederick L. Brancati , MD, MHS 7 and the Look Ahead Research Group 1 Departments of Preventive Medicine and Epidemiology and Medicine, Division of Nephrology and Hypertension, Loyola University Medical Center, Maywood, Illinois; 2 Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina; 3 Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina; 4 Department of Medicine, Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, Washington; 5 Department of Medicine, Division of Metabolism and Endocrinology, University of Washington and VA Puget Sound Health Care System, Seattle, Washington; 6 Pennington Biomedical Research Center, the Louisiana State University System, Baton Rouge, Louisiana; 7 Departments of Medicine and Epidemiology, Johns Hopkins University, Baltimore, Maryland. Corresponding author: Holly Kramer, hkramer{at}lumc.edu Abstract 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 albuminuria 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. Footnotes The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indica