Association between abdominal CT-based body composition parameters and early diabetic kidney disease in type 2 diabetes mellitus: a retrospective cross-sectional study.

Four independent risk factors for early DKD were identified by multivariate logistic regression: age, high-sensitivity C-reactive protein, renal sinus fat index, and renal sinus fat density.

• Age: OR = 1.03, 95% CI [1.01–1.06], P = 0.044
• High-sensitivity C-reactive protein: OR = 1.02, 95% CI [1.01–1.04], P = 0.005
• Renal sinus fat index: OR = 0.50, 95% CI [0.30–0.85], P = 0.010
• Renal sinus fat density: OR = 0.79, 95% CI [0.74–0.85], P < 0.001
• Study enrolled 310 T2DM patients stratified into early DKD group (n = 131) and T2DM control group (n = 179)

Renal sinus fat density was significantly associated with both urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) after adjusting for confounding variables.

• Association with UACR: β = -1.88, P < 0.001
• Association with eGFR: β = 0.22, P = 0.017
• Associations were identified using multiple linear regression analysis
• The negative β for UACR indicates that lower renal sinus fat density corresponds to higher albuminuria

The combined clinical-body composition model demonstrated superior predictive performance for early DKD compared to the clinical-only model.

• Combined clinical-body composition model AUC = 0.81, 95% CI [0.76–0.86]
• Body composition-only model AUC = 0.77, 95% CI [0.72–0.82]
• Clinical-only model AUC = 0.67, 95% CI [0.61–0.73]
• ROC curve analysis was used to assess predictive value of body composition parameters for early DKD

Body composition parameters were measured at the L3 vertebral level on abdominal CT images using Slice-O-Matic software, including area, index, and radiodensity of skeletal muscle and adipose tissue depots.

• Parameters included skeletal muscle and adipose tissue compartments measured at the L3 vertebral level
• Measurements included area, index (area normalized to height squared), and radiodensity for each compartment
• Renal sinus fat was among the adipose tissue depots assessed
• Spearman correlation analysis was used to evaluate associations between body composition parameters and renal function indicators

The study was a retrospective cross-sectional analysis of T2DM patients from a single center spanning January 2020 to December 2024.

• 310 total patients enrolled from the Second Hospital of Ningbo
• Early DKD group: n = 131; T2DM control group without DKD: n = 179
• Patient stratification was based on renal function assessment results
• Both univariate and multivariate logistic regression analyses were performed to identify independent risk factors