Association of Predicted Lean Body Mass and Fat Mass With Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus: A Post Hoc Analysis of ACCORD Trial

Abstract

BackgroundLean body mass (LBM) and fat mass (FM) have been shown to have different associations with several chronic diseases but little is known about the sex-specific association of LBM and FM with diabetic nephropathy (DN) risk among participants with diabetes.MethodsParticipants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used in a post hoc analysis to examine the association of predicted LBM index (LBMI) and FM index (FMI) with incident DN risk (defined as a composite outcome of three types of predefined DN). Because of sex differences in body composition, analyses were conducted separately using sex-specific quartiles of predicted LBMI and FMI.ResultsOf the 9,022 participants with type 2 diabetes (5,575 men and 3,447 women) included in this study, 5,374 individuals developed DN (3,396 in men and 1,978 in women). Higher quartiles of LBMI were associated with a reduced risk of DN while higher quartiles of FMI were associated with an increased higher risk of DN among men but not women. Compared with the lowest quartile, the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs)for the highest quartile of predicted LBMI and FMI were respectively 0.83 (95% CI 1.71 – 0.96) and 1.23 (95% CI 1.06-1.43) among men; and 0.92 (95% CI 0.63 – 1.33) and 1.14 (95% CI 0.79 – 1.63) among women.ConclusionsAmong participants with diabetes, predicted LBMI was inversely associated with risk of DN while predicted FMI was positively associated with an increased risk of incident DN among men but not women. Trial registration: ClinicalTrials.gov., no. NCT00000620.

The role of predicted lean body mass and fat mass in non-alcoholic fatty liver disease in both sexes: Results from a secondary analysis of the NAGALA study

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Genome‐wide DNA methylation analysis of body composition in Chinese monozygotic twins

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“…5 People with the same BMI are likely to have different body composition which may function differently in leading to obesity and its associated phenotypes. 6 Therefore, EWAS on detailed body composition is warranted. Of note, direct measurement of body composition comes at a high cost and requires sophisticated technologies which limit their utilization.…”

Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis

“…With the paucity of studies on the association between lipid variability and microvascular complication, we conducted a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial to examine the relationship between intraindividual variability in HDL, LDL, triglyceride, and remnant cholesterol (RC) with diabetic microvascular complication. The ACCORD trial was a randomized, multicenter, double 2 × 2 factorial trial in 10 251 participants with T2DM 23 . The current study gives a unique sample of participants with T2DM, with comprehensive baseline measurements and almost complete follow‐up for diabetic microvascular complications, including nephropathy, neuropathy, and retinopathy.…”

“…The ACCORD trial was a randomized, multicenter, double 2 × 2 factorial trial in 10 251 participants with T2DM. 23 The current study gives a unique sample of participants with T2DM, with comprehensive baseline measurements and almost complete follow‐up for diabetic microvascular complications, including nephropathy, neuropathy, and retinopathy.…”