Correlation of Body Mass Index with Clinicopathologic Parameters in Patients with Idiopathic Membranous Nephropathy

Xing Chen; Shuchun Chen; Zelin Li; Xiaoyu Pan; Yujiao Jia; Zhijuan Hu; Kai Niu; Bing Liu; Qingjuan Ren

doi:10.2147/DMSO.S366100

Correlation of Body Mass Index with Clinicopathologic Parameters in Patients with Idiopathic Membranous Nephropathy

Diabetes Metab Syndr Obes. 2022 Jun 20:15:1897-1909. doi: 10.2147/DMSO.S366100. eCollection 2022.

Authors

Xing Chen¹, Shuchun Chen^{1

2}, Zelin Li¹, Xiaoyu Pan¹, Yujiao Jia¹, Zhijuan Hu³, Kai Niu³, Bing Liu³, Qingjuan Ren¹

Affiliations

¹ Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People's Republic of China.
² Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People's Republic of China.
³ Department of Nephrology, Hebei General Hospital, Shijiazhuang, People's Republic of China.

Abstract

Objective: To investigate the association between body mass index (BMI) and clinicopathologic parameters in patients with idiopathic membranous nephropathy (IMN).

Methods: This study was retrospective and included patients with biopsy-proven IMN from 2018 to 2021 in Hebei General Hospital. Patients were categorized into two groups based on BMI. Clinical and histopathologic data were analyzed at the time of renal biopsy. Pathological data included immunofluorescence staining, glomerulosclerosis (GS, 0-2), mesangial cell proliferation (MCP, 0-1), tubular atrophy (TA, 0-1), interstitial fibrosis (IF, 0-1), vascular wall thickness (VWT, 0-1) and a combination score (GMTIV) graded from 0 to 5.

Results: Our study revealed that the obese group had a higher prevalence of hypertension and diabetes than the overweight/normal weight group (P=0.001, P=0.002). Systolic blood pressure (P=0.005), diastolic blood pressure (P<0.001), haemoglobin (P=0.006), triglycerides (P<0.001), serum uric acid (P=0.05), 24 h urine proteinuria concentration (UP) (P=0.012), MCP (P=0.042), IF (P=0.033), and GMITV (P=0.033) score were higher in obese group compared to the other group, while the high-density lipoprotein-cholesterol (P=0.034) and immunoglobulin A deposition score (P=0.005) were lower. Factors significantly associated with UP were the ratio of lymphocyte count to white blood cell count, serum pre-albumin, immunoglobulin G, microscopic hematuria, anti-phospholipase A2 receptor (anti-PLA2R), C3 deposit on multivariable analysis (adjusted R ²=0.343). Binary logistic regression analysis illustrated that MCP was correlated to BMI (OR=2.528, P=0.036). Ordinal logistic regression analysis demonstrated that GMTIV was associated with BMI (OR=1.114, P=0.010) and C3 deposit (OR=1.655, P=0.001).

Conclusion: High BMI was associated with MCP and GMTIV score in IMN patients. Obesity may play an essential role in mesangial lesions of IMN. This study emphasized the relation between BMI and histological parameters under the universal usage of anti-PLA2R antibodies for diagnosis and prognosis in IMN.

Keywords: body mass index; idiopathic membranous nephropathy; obesity.