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



Miri M ; Karimi Ghahfarokhi M ; Mohseni S ; Golestani A ; Akbarpour S ; Pejman Sani M ; Tabatabaei Malazy O
Authors

Source: Endocrinology, Diabetes and Metabolism Published:2026


Abstract

Aims: 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. Methods: 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. Results: 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. Conclusion: 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. © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
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