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Indicadores antropométricos y descontrol glucémico en diabetes tipo 2 con enfermedad renal / Anthropometric indicators and poor glycemic control in type 2 diabetes with kidney disease
Resumen
Resumen
Introducción: la relación de los indicadores antropométricos y de composición corporal, con la evolución de la enfermedad renal en pacientes con diabetes tipo 2 sigue siendo controversial.
Objetivo: identificar la asociación de los indicadores de la enfermedad renal con indicadores de control metabólico y antropométricos en pacientes con diabetes tipo 2.
Material y métodos: se realizó un estudio transversal analítico en 395 pacientes del primer nivel de atención. La glucosa, hemoglobina glucosilada (HbA1c), perfil de lípidos y creatina se midió en ayuno. La enfermedad renal crónica (ERC) se consideró cuando la excreción de albumina urinaria (EAU) > 30 mg/g y con la reducción del nivel de la tasa de filtrado glomerular < 60 mL/min/1.73 m2, utilizando la ecuación CKD-EPI. Se midió el peso y circunferencia de cintura, así como la composición corporal a través de bioimpedancia.
Resultados: un 17% de la población presentó ERC con alteración de la EAU y 6.6% con una TFG reducida. Un mayor tiempo de diagnóstico de la enfermedad, mayor nivel de HbA1c y menor nivel grasa corporal se asoció a una EAU > 30 mg/g, (p < 0.05). La disminución de la TFG (< 60 mL/min/1.73 m2) se asoció con mayor edad, ser mujer, tener mayor circunferencia de cintura y menor porcentaje de grasa corporal (p < 0.05).
Conclusiones: un mayor nivel de circunferencia de cintura y menor porcentaje de grasa corporal se asocian a mayor evolución de la ERC en pacientes con diabetes tipo 2. El descontrol glucémico se identificó en pacientes con mayor excreción de albumina urinaria.
Abstract
Background: The relationship of anthropometric and body composition indicators with the evolution of kidney disease in patients with type 2 diabetes, is still inconsistent.
Objective: To identify the association of indicators of kidney disease with indicators of metabolic and anthropometric control in patients with type 2 diabetes.
Material and methods: An analytical cross-sectional study was carried out in 395 patients of the first level of care. The glucose, glycosylated hemoglobin (HbA1c), creatinine and lipid profile were measured. The kidney disease (CKD) was made when urinary albumin excretion (UAE) > 30 mg/g and with a reduction in the level of glomerular filtration rate < 60 mL/min/1.73 m2, using the CKD-formula. Weight and waist circumference were measured, as well as the body composition through bioimpedance.
Results: Seventeen percent of the population has a diagnosed with CKD with alteration of the UAE and 6.6% had a reduced GFR. A longer time of diagnosis of the diabetes, higher HbA1c level and body fat were associated with an UAE > 30 mg/g, (p < 0.05). The decline in GFR (< 60 mL/min/ 1.73 m2) was associated with older age, being a woman, greater waist circumference, and a higher percentage of body fat (p < 0.05).
Conclusions: A higher level of waist circumference and a lower percentage of body fat are associated with a greater evolution of chronic kidney disease in patients with type 2 diabetes. Glycemic uncontrol is identified in patients with high urinary albumin excretion.
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