| Abstract: | Objective To study the effect of baseline weight and its change on new-onset albuminuria or increased urine albumin/creatinine ratio (ACR) in the physical examination population. Methods The subjects of this study were those who completed two or more physical examinations at the Physical Examination Center of Sichuan Provincial People's Hospital from September 1, 2013 to September 1, 2018. The general information and laboratory examination results at the first and last physical examinations were collected. According to body mass index (BMI), they were divided into normal BMI group and overweight/obese group. The differences in general clinical data and laboratory test results between the two groups were compared. The primary endpoint events were new-onset albuminuria or urine ACR increase≥30%. Stepwise multiple linear regression method was used to analyze the influencing factors for ACR increase, and Cox proportional hazard model method was used to analyze the impact of baseline weight and its change on new-onset albuminuria or ACR increase≥30%. Results A total of 1 761 physical examination subjects were included in this study. The follow-up time was (16.54±7.87) months. There were 59 patients with new-onset albuminuria, 30 patients with ACR increase≥30%, and 35 patients with albuminuria reversal. Multiple linear regression analysis showed that BMI was an independent influencing factor for ACR ( β=0.127, P＜0.001). Cox regression analysis showed that the older age (HR=1.041, 95%CI 1.018-1.064, P＜0.001), hypertension (HR=2.035, 95%CI 1.278-3.242, P=0.003), diabetes (HR=2.081, 95%CI 1.310-3.305, P=0.002) and hyperuricemia (HR=1.700, 95%CI 1.084-2.668, P=0.021) were independent influencing factors for new-onset albuminuria or ACR increase≥30%, while BMI (HR=1.053, 95%CI 0.975-1.137, P=0.191) and weight change rate (HR=1.030, 95%CI 0.972-1.092, P=0.322) were not independent influencing factors for endpoint events. Subgroup analysis indicated that overweight/obesity had interactions with age, hypertension, diabetes, and hyperuricemia, respectively (P for interaction＜0.05), and the effects of overweight/obesity on the pre-set primary endpoint events in each subgroup were basically consistent. There were interactions between weight gain and hypertension and diabetes (P for interaction＜0.05). Weight gain increased the risk of the primary endpoint events of women (HR=3.355, 95%CI 1.164-9.670, P=0.025), and the effects of overweight/obesity on the pre-set primary endpoint events of each subcomponent were basically the same (all P﹥0.05). The incidence of albuminuria reversal in the group with obvious weight loss was slightly higher than that in the group with obvious weight gain, but the difference was not statistically significant (P﹥0.05), which might be related to the small weight loss range (-6.08%±3.51%). Conclusions Overweight or obesity may increase the risk of albuminuria, and people with diabetes, hypertension, and hyperuricemia may be more likely to occur. Mild weight loss is not enough to reverse albuminuria. |
