The interaction between eGDR and visceral adiposity in renal function decline among middle-aged and elderly diabetes patients: findings from a nationwide Chinese cohort

BACKGROUND: Both insulin resistance and visceral adiposity, which can be measured by the estimated Glucose Disposal Rate (eGDR) and Chinese Visceral Adiposity Index (CVAI), are related to the decline of renal function in diabetes patients, but the relationship between them and renal function decline in diabetes patients remains unclear. AIM: To explore the independent and interaction effect of eGDR and CVAI on the renal function of diabetes patients. METHOD: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2011 and 2015. In this study, eGDR and CVAI were firstly treated as numeric variables, and then wereclassified into "low" and "high" groups, respectively, based on their median values. Logistic and linear regression models were applied to explore the relationship between eGDR, CVAI and rapid renal function decline and ΔeGFR. Multiplicative and additive interaction analyses were conducted to evaluate interaction between the two indexes. Subgroup analysis was then conducted to explore the independent and interaction effect of them across different population. RESULTS: A total of 1133 participants were selected to participate in the study. Multivariate logistic regression results revealed significant independent positive association of high CVAI with rapid decline of renal function, but no significant relationship between low eGDR, interaction and rapid decline of renal function were observed. Linear regression results indicated that both low eGDR and high CVAI had a negative relationship with ΔeGFR, and the interaction was significant. The results of subgroup analyses were consistent with the main analyses. CONCLUSION: High CVAI was observed to be related with rapid decline of renal function, while no significant relationship of eGDR, interaction, and rapid decline of renal function was observed. Low eGDR and high CVAI are negative associated with ΔeGFR, respectively. Notably, there exists multiplicative interaction betweenthem on ΔeGFR.