Study reveals positive impact of weight loss on proteinuria outcomes in patients with type 2 diabetes

The association remained consistent across several subgroups, a particularly robust impact was, however, observed in males, demonstrating a 6% UACR regression for every 1kg weight loss. The findings were published online in Diabetes Research and Clinical Practice on November 16, 2023.

Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease (ESRD) in developed countries and significantly raises the risk of cardiovascular disease. It is important to emphasize that diabetes and obesity occurring in the context of obesity (known as diabesity) have emerged as a leading cause of CKD. While obesity is closely related to T2D and hypertension, two common risk factors for proteinuria, studies have also shown that the impact of obesity on kidney disease risk is independent of these risk factors.

The study was conducted by Wenqian Ren, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and colleagues to assess the impact of weight loss on proteinuria in patients with type 2 diabetes in real-world settings.

For this purpose, the researchers categorized 1054 participants based on weight changes from baseline to one-year follow-up: weight loss (≥ 3%), stable weight, or weight gain (≥ 3%). Proteinuria outcomes were defined as UACR progression (≥ 30% increase), UACR stable, or UACR regression (≥ 30% reduction). The relationship between weight loss and UACR regression was evaluated using ordered logistic regression analysis.

The study revealed the following findings:

• Of the 1054 participants, 24.1% were obese, and 44.5% were overweight.
• Patients with obesity were at higher risk of developing proteinuria (OR, 1.783).
• Weight loss was associated with an 83.3% increase in UACR regression compared to weight gain (OR, 1.833).
• This association remained consistent across most subgroups and stronger in males, with a 6% UACR regression for every 1kg weight loss (OR, 1.06).

"Our findings indicate a strong correlation between body mass index (BMI) and proteinuria occurrence, with higher BMI patients at greater risk of developing proteinuria," the researchers wrote. They noted that after a one-year follow-up, weight loss led to some extent of proteinuria improvement in patients with type 2 diabetes whatever weight management they adopted.

Reference:

Ren, W., Gong, Y., Zhen, Q., Gu, L., Yang, J., Kang, M., Zhang, A., Shen, T., Wang, Y., Liu, F., & Li, N. (2023). Effect of Weight Loss on Proteinuria in Adults with Type 2 Diabetes: A Real-world Study. Diabetes Research and Clinical Practice, 111021. https://doi.org/10.1016/j.diabres.2023.111021