Association of anthropometric and biochemical–anthropometric obesity indices with chronic kidney disease in diabetes: a KNHANES-based study

BACKGROUND: Obesity is a known risk factor for diabetes mellitus (DM) and chronic kidney disease (CKD), yet the relationship between various obesity-related indices and CKD remains unclear. This study evaluated the associations between eight obesity indices with CKD and identified the most useful index among patients with DM. METHODS: This study used data from the Korean National Health and Nutrition Examination Survey conducted from 2007 to 2018. A total of 5,067 participants aged ≥ 20 years with DM were included. The study evaluated four traditional anthropometric obesity indices (body mass index [BMI], waist-to-height ratio [WHtR], body roundness index [BRI], conicity index [CI]) and four biochemical-anthropometric indices, including two Asian-specific indices (lipid accumulation product [LAP], visceral adiposity index [VAI], Chinese visceral adiposity index [CVAI], and new visceral adiposity index [NVAI]). RESULTS: WHtR, BRI, CI, CVAI, and NVAI were higher in males with CKD, while only CI, CVAI, and NVAI were elevated in females. All eight indices were independently associated with CKD risk in males, whereas only the anthropometric-biochemical indices LAP, VAI, and CVAI were significantly associated with CKD in females. NVAI in males and CVAI in females exhibited the highest area under the curve values of 0.615 and 0.658, respectively. CONCLUSIONS: Various obesity indices were associated with CKD in patients with DM, although the associations differed by sex. Asian-specific indices may be the most useful for reflecting CKD in patients with DM.