Overweight/obesity accelerates proteinuria progression in type 2 diabetes post-COVID-19: a comparison with a...

To assess whether overweight/obesity accelerates proteinuria progression in patients with type 2 diabetes mellitus (T2DM) after coronavirus disease 2019 (COVID-19) infection.

This retrospective study included 688 patients with T2DM confirmed to have COVID-19 infection and 502 pre-pandemic uninfected patients with T2DM for comparative analysis. Participants were categorized based on body mass index (BMI) into normal weight (BMI <24 kg/m²) and overweight/obese (BMI ≥24 kg/m²) groups. Proteinuria progression, defined as an increase in albuminuria stage, was assessed within three months pre- and post-infection. Multiple logistic regression analysis was used to evaluate the association between body weight status and proteinuria progression after COVID-19 infection.

Of the 688 infected participants, 8.5% experienced proteinuria progression. Within the infected cohort, the incidence of progression in the overweight/obese group (10.8%) was significantly higher than in the normal weight group (4.9%, P = 0.012). Critically, the incidence of progression in the infected overweight/obese group (10.8%) was also significantly higher than that in their uninfected overweight/obese counterparts (5.8%, P = 0.016). In the COVID-19 infection cohort, overweight/obese was associated with a 2.682-fold higher risk of proteinuria progression after COVID-19 infection compared to the normal weight group (OR, 2.682; 95%CI, 1.273-5.648; P = 0.009). Furthermore, every 1 kg/m² increase in BMI was associated with a 13.1% increased risk of proteinuria progression after COVID-19 infection (OR, 1.131; 95% CI, 1.039 -1.23; P = 0.004).

Overweight/obese accelerates proteinuria progression in patients with T2DM following COVID-19 infection. Therefore, emphasizing the importance of obesity management is crucial to prevent renal complications in patients with T2DM after COVID-19.