Endocrine Abstracts

Introduction: Excess weight has become a major public health problem. Type 2 diabetes and obesity are known risk factors for kidney disease. The aim of this study is to determine the effect of obesity on glomerular filtration rate (GFR) and microalbiminuria in patients with diabetes.

Methods: This is a descriptive cross-sectional study conducted over three years in obese and type 2 diabetic patients hospitalized in the Endocrinology and Diabetology Department of the Mohamed VI University Hospital in Marrakech.

Parameters studied: * BMI, BP, Waist circumference, lipid balance. * Renal function. * GFR was determined by measuring plasma creatinine clearance (MDRD). * Microalbiminuria was measured on a 24-hour urine sample.

Results: -Population: 31 obese

-Sex ratio: 0.32

-Predominance: female

-Average age: 55.5 years (42–69 years).

- prevalence: severe obesity: 13.6% of diabetics morbid obesity: 86.36% of diabetics

-Average BMI: severe obesity: 38.1 kg/m2 morbid obesity: 52.5 kg/m2

-Average duration of diabetes: 8.4 years.

-The average GFR: 76.70±20.41 ml/min for BMI > 30 64.49±13.26 ml/min for BMI > 40

-. Prevalence of microalbiminuria:

* in type 2 diabetics with severe obesity: 21.13±6.85%

* in type 2 diabetics with morbid obesity: 55±11.45%.

Discussion: Obesity contributes to the parallel increase in the prevalence of chronic kidney disease, through: nephropathy associated with type 2 diabetes and hypertension. The existence of a metabolic syndrome, as well as the constant inflammatory state in obese type 2 diabetics, contributes to the development of glomerular sclerosis lesions. In our series we observed an interaction between the effect of obesity and type 2 diabetes on GFR. We also observed a strong interaction between the effect of obesity and T2DM on renal function with a reduction in GFR and an increase in microalbiminuria in morbidly obese patients.

Conclusion: Obesity is not only a cardiovascular risk factor, but also a renal risk factor. It is therefore essential to detect and treat high-risk patients. Therefore, testing for proteinuria and measuring renal function is indicated in all obese patients.