Impact of extracellular-to-intracellular fluid volume ratio on albuminuria in patients with type 2 diabetes: A cross-sectional and longitudinal cohort study.
Aged
Albumins
/ analysis
Albuminuria
/ diagnosis
Creatinine
/ urine
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ complications
Electric Impedance
Extracellular Fluid
Female
Humans
Intracellular Fluid
Longitudinal Studies
Male
Middle Aged
ROC Curve
Reference Values
Regression Analysis
Risk Assessment
Water-Electrolyte Balance
Water-Electrolyte Imbalance
/ diagnosis
Body fluid volume
Diabetic kidney disease
Fluid overload
Journal
Journal of diabetes investigation
ISSN: 2040-1124
Titre abrégé: J Diabetes Investig
Pays: Japan
ID NLM: 101520702
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
27
10
2020
received:
03
04
2020
accepted:
30
10
2020
pubmed:
5
11
2020
medline:
11
11
2021
entrez:
4
11
2020
Statut:
ppublish
Résumé
Body fluid volume imbalance is common in patients with kidney failure, and is associated with all-cause mortality. This study aimed to investigate the association between fluid volume imbalance and albuminuria in patients with type 2 diabetes mellitus without kidney failure. Using data from one cohort study, a baseline cross-sectional study of 432 participants and a longitudinal cohort study of 368 participants who could follow up was carried out. Body fluid imbalance was determined by measuring the extracellular water (ECW)-to-intracellular water (ICW) ratio (ECW/ICW) using bioelectrical impedance analysis. A change in the urinary albumin-to-creatinine ratio (ACR) was defined as the ratio of urinary ACR at follow up to that at baseline. The ECW/ICW ratio was compared with the level of albuminuria. In this cross-sectional study, the ECW/ICW ratio increased with the level of albuminuria. There was an association between the ECW/ICW ratio and logarithms of urinary ACR after adjusting for covariates (β = 0.205, P < 0.001). Furthermore, the ECW/ICW ratio was associated with a change in the urinary ACR after adjusting for covariates (β = 0.176, P = 0.004) in this longitudinal study. According to the receiver operating characteristic curve, the optimal cut-off point of the ECW/ICW ratio for incident macroalbuminuria, defined as ACR >300 mg/gCr, was 0.648 (area under the curve 0.78, 95% confidence interval 0.58-0.90). The ECW/ICW ratio is independently associated with the level of albuminuria in patients with type 2 diabetes mellitus without kidney failure. This reinforces the importance of monitoring fluid balance in patients with type 2 diabetes mellitus.
Identifiants
pubmed: 33145975
doi: 10.1111/jdi.13459
pmc: PMC8264398
doi:
Substances chimiques
Albumins
0
Creatinine
AYI8EX34EU
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1202-1211Informations de copyright
© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
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