Waist-to-Height Ratio Is Independently and Better Associated With Urinary Albumin Excretion Rate Than Waist Circumference or Waist-to-Hip Ratio in Chinese Adult Type 2 Diabetic Women but Not Men

Extreme obesity has been shown to be associated with focal-segmental glomerulosclerosis and nephrotic syndrome in a report of four cases (1). However, this association has not gained much attention until recently when histologically proven glomerulopathy was demonstrated in animals (2) and humans (3). The study of renal biopsy taken from humans included mostly patients with clinical proteinuria or proteinuria with renal insufficiency (3). Therefore, whether obesity is associated with nephropathy in the early stage of microalbuminuria is not yet proven. This study evaluated the effects of the commonly used indicators for obesity (i.e., BMI, waist circumference, waist-to-hip ratio [WHR], and waist-to-height ratio [WHeiR]) on the urinary albumin excretion rate (UAER) in the early normo- or microalbuminuric stages in type 2 diabetic patients. A total of 569 (282 men and 286 women) type 2 diabetic patients, aged 63.6 ± 11.0 years, were recruited. Measurements of body height, body weight, waist circumference, and hip circumference were described elsewhere (4). BMI was calculated as body weight (in kilograms) divided by the square of height (in meters). WHR and WHeiR were calculated by dividing the waist circumference by the hip circumference and the body height, respectively. The patients’ age, sex, diabetes duration, and systolic (sBP) and diastolic blood pressure (dBP) were recorded or measured. Urine specimens and blood samples were collected in …