Evaluating Abdominal Obesity and BMI As Risk Factors for Diabetic Nephropathy in Patients With Type 2 Diabetes Mellitus: A Case-Control Study.

Introduction Diabetic nephropathy (DN) is a major microvascular complication of type 2 diabetes, contributing significantly to chronic kidney disease (CKD) and end-stage renal failure. Obesity, particularly central obesity, has emerged as a potential risk factor; however, its role in DN remains uncertain. This study aimed to determine the association of central obesity and BMI with DN in patients with type 2 diabetes mellitus. It also sought to evaluate the role of waist circumference (WC), HbA1c, and lipid profile as potential metabolic predictors of nephropathy risk. Material and methods A case-control study was conducted from March to September 2024 in Peshawar, involving 98 cases and 49 controls. Patients were matched for age, and data were collected on BMI, HbA1c, WC, and proteinuria. Statistical analyses included correlation, regression analysis, and Chi-square tests using IBM SPSS version 20. Results The study included 98 cases and 49 controls, with a mean age of 55.9 ± 13.2 years. The gender distribution was 56% female in the case group and 49% in the control group. Chi-square analysis revealed significant associations between DN and WC (OR = 2.71), duration of diabetes (OR = 2.78), BMI, HbA1c, oral antidiabetic medication use, and dyslipidemia. Proteinuria showed a moderate, significant positive correlation with BMI (r = 0.402), HbA1c (r = 0.432), and low-density lipoprotein (LDL, r = 0.242). A weak but significant positive correlation was observed with WC (r = 0.231), triglycerides (r = 0.197), and total cholesterol (r = 0.221). Regression analysis identified BMI, HbA1c, and duration of diabetes as significant risk factors. Conclusion Abdominal obesity, as indicated by WC, was significantly associated with DN in patients with type 2 diabetes mellitus. BMI, HbA1c, and diabetes duration were key risk factors, highlighting the need for comprehensive metabolic management in assessing DN risk.