Association of Selected Anthropometric Indices With Diabetic Kidney Disease Among Iranian Adults With Diabetes

This study evaluated the association and discriminative ability of several lipid- and adiposity-related indices-triglyceride-glucose (TyG), TyG-body mass index (TyG-BMI), waist-triglyceride index (WTI), visceral adiposity index (VAI) and lipid accumulation product (LAP)-with diabetic kidney disease (DKD) among Iranian adults with diabetes.

In this nationwide cross-sectional study, data were obtained from 3272 diabetic individuals aged ≥ 25 years who participated in the 2021 world health organization (WHO) STEPwise approach to Noncommunicable Disease Risk Factor Surveillance (STEPS) survey. Survey-weighted multivariable logistic regression models were applied for each index, adjusting for demographic, lifestyle, clinical and medication-related factors. Discriminative performance was evaluated using receiver operating characteristic (ROC) curves.

Overall, 27.9% of participants had DKD. Individuals with DKD exhibited significantly higher mean values across all studied indices (p < 0.001). In adjusted analyses, each one-standard deviation (SD) increase in TyG, TyG-BMI, WTI, VAI and LAP was associated with 36%, 20%, 27%, 24% and 27% higher odds of DKD, respectively (all p < 0.001). All indices demonstrated moderate discriminative performance, with area under the curve (AUC) values ranging from 0.696 to 0.704; however, no significant differences were observed in their discriminatory ability.

In this large sample of Iranian adults with diabetes, low-cost indices were associated with DKD and may help identify high-risk individuals, particularly in resource-limited settings. However, their moderate discriminative performance suggests limited standalone diagnostic utility, and longitudinal studies are needed to establish their predictive value.