Chinese research reveals that tailored obesity and metabolic indicators, varying by sex, could enhance early detection of kidney risks in people with type 2 diabetes, paving the way for personalised screening approaches.
A Chinese study published in Diabetes, Metabolic Syndrome and Obesity has found that several obesity-related markers are linked with diabetic kidney disease in people with type 2 diabetes, but the most useful indicator differs by sex. The findings add to a growing body of research suggesting that kidney risk in diabetes is shaped not just by weight, but by how fat is distributed and how strongly it interacts with insulin resistance.
The research team analysed 1,586 adults with type 2 diabetes from China’s Metabolic Management Center database between 2020 and 2022. Diabetic kidney disease was present in 37.3% of the group. In fully adjusted analyses, all eight obesity-related measures examined were associated with higher kidney-disease risk, although the gains in prediction were modest. Among the whole cohort, the triglyceride-glucose-waist circumference measure performed best overall, while triglyceride-glucose body mass index was the strongest predictor in men and triglyceride-glucose waist-to-height ratio was strongest in women.
The results fit with earlier studies showing that visceral adiposity and triglyceride-glucose-based indices can help identify patients at higher risk of kidney complications. A recent PubMed-indexed study also reported that visceral adiposity markers, including the triglyceride-glucose index and the lipid accumulation product, were linked to diabetic kidney disease, with stronger associations in women for some measures. A separate meta-analysis published in Frontiers in Endocrinology found that the visceral adiposity index was moderately predictive of kidney disease and appeared to carry a somewhat stronger association in women than in men.
The new study also reinforces the broader clinical view that diabetic kidney disease is not experienced identically by men and women. Previous reviews have pointed to sex hormones, fat distribution and differences in renal protection as possible reasons for this gap. In the Chinese cohort, the waist-to-height measure was particularly informative in women, including those who had gone through menopause, and the association looked stronger in participants with higher systolic blood pressure. That matters because it suggests blood pressure control and body-shape measures may need to be interpreted together rather than separately.
The authors stressed that the findings should not be treated as proof of causality. The study was cross-sectional, meaning it shows association rather than cause and effect, and it was limited to Chinese patients with type 2 diabetes. Even so, the work supports a more personalised approach to screening: rather than relying only on conventional measures such as body mass index, clinicians may need to consider sex-specific combinations of obesity and metabolic markers when assessing kidney risk.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
