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. 2025 Jun 18;17(1):225.
doi: 10.1186/s13098-025-01814-5.

Association between abdominal fat distribution and urinary albumin/creatinine ratio in patients with type 2 diabetes mellitus

Tianlu Shi #  1   2 , Ying Yang #  3 , Yunxia Liu  1   2 , Min Zhang  1 , Junran Shu  1 , Shujin Wang  1 , Tianxiao Zhang  4 , Yu Niu  5
Affiliations

Association between abdominal fat distribution and urinary albumin/creatinine ratio in patients with type 2 diabetes mellitus

Tianlu Shi et al. Diabetol Metab Syndr. .

Abstract

Objective: This study aimed to assess the relationship between abdominal fat distribution (AFD) and urinary albumin/creatinine ratio (UACR) in Chinese adults.

Methods: 823 patients with type 2 diabetes mellitus(T2DM) were selected. Abdominal visceral fat area (VFA) and subcutaneous fat area (SFA) were measured using bioelectrical impedance analysis (BIA). Patients were divided into four groups: low VFA /low SFA, low VFA /high SFA, high VFA /low SFA, and high VFA /high SFA based on the median values (low: < median, high: ≥median).

Results: In the multifactor analysis after adjusting for relevant factors, VFA, waist-to-height ratio (WHtR), waist-hip ratio (WHR), and waist circumference (WC) showed significant positive correlations with UACR, while SFA and BMI did not. AFD combinations were independent predictors of UACR. The risk of UACR30-300 mg/g was highest in the high VFA/low SFA group (OR = 3.12), and for UACR > 300 mg/g, it was highest in the high VFA/high SFA group (OR = 24.69). The areas under the receiver operating characteristic (ROC) curvefor VFA prediction of UACR ≥ 30 mg/g was 0.69, significantly greater than that for WHtR, WHR, and WC. Optimal cut-off values were 98.8 cm² for VFA. When analyzed by gender, the optimal cut-off values for VFA were 98.8 cm² for males and 102.3 cm² for females.

Conclusion: Central obesity indicators (VFA, WHtR, WHR, WC) were associated with UACR. VFA was the strongest predictor for UACR ≥ 30 mg/g.

Keywords: Abdominal fat distribution; Subcutaneous fat area; Type 2 diabetes mellitus; Urinary albumin/Creatinine ratio; Visceral fat area.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The research adhered to the guidelines of the Helsinki Declaration and was approved by the Ethics Committee of Xi’an Ninth Hospital (IRB number: 202275). Each participant provides written informed consent. Consent for publication: Not applicable. Conflict of interest: All the authors declare that there is no conflict of interest. Declaration of generative AI and AI-assisted technologies in the writing process: During the preparation of this work we used the Large Language Model (ChatGPT) in order to refine grammar and language. After using this tool, we reviewed and edited the content as needed and take full responsibility for the content of the publication.

Figures

Fig. 1
Fig. 1
ROC curves and AUC of VFA, WHR, WHtR, WC to predict UACR ≥ 30 mg/g. (a) Overall (b) Male (c) Female (d) AUC of VFA, WHR, WHtR, WC
See this image and copyright information in PMC

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