Factors associated with albuminuria in non-diabetic severe obesity

to analyze the association between clinical factors and the presence of albuminuria in non-diabetic patients with obesity.

retrospective, single-center observational study in a population of adult patients with severe obesity but without diabetes. Two groups were defined: patients with albuminuria ≥30 mg/24h and those with albuminuria <30 mg/24h.

Among the 254 patients (mean ± standard deviation, age 43.5 ± 13.1 years; BMI 43.5 ± 6.0 kg/m²), 16.9% of patients had albuminuria ≥30 mg/24h (95% confidence interval: 12.5 to 22.1). Male gender (48.8% vs. 25.6%, p = 0.002), weight (130.9 ± 25.4 kg vs. 118.7 ± 21.7 kg, p = 0.005), cardiovascular risk (Framingham risk: 2.46 [0.61; 6.68] vs. 0.92 [0.20; 3.09], p = 0.007), albumin-to-creatinine ratio (5.64 [2.46; 8.78] vs. 0.84 [0.56; 1.15], p < 0.001) and plasma triglycerides (1.62 g/l [1.16; 2.28] vs. 1.30 g/l [1.04; 1.85], p = 0.049) appeared significantly associated with the presence of albuminuria. The metabolic syndrome and the metabolic syndrome severity score were not significantly associated with the presence of albuminuria. In the multivariable analysis, high triglyceridemia was mostly associated with a risk of albuminuria (odds ratio: 3.59, 95% confidence interval: 1.09 to 11.89, p = 0.04).

In patients with severe obesity, early signs of renal failure should be systematically detected regardless of metabolic status. Nevertheless, both metabolic (hypertriglyceridemia) and non-metabolic factors (male gender and weight) were associated with renal impairment. The limited power of this study to fully assess the role of metabolic syndrome should be acknowledged.