Association Between Atherogenic, Thrombogenic, and Lipophilic Indices and the Odds of Diabetic Nephropathy in Type 2 Diabetic Patients: A Case–Control Study

Abstract

The quality of fats in the diet affects the development of chronic kidney disease. In this study, we aimed to understand the relationship between dietary fat markers and the risk of diabetic nephropathy (DN) in patients with Type 2 diabetes (T2DM).In this case retrospective study, 309 patients with T2DM (151 with DN, and 158 without DN) were included. A 147 item questionnaire measuring food frequency and the International Physical Activity Questionnaire (IPAQ) were used. Anthropometric indices, and biochemical factors were measured or recorded from the patient's files. Quantitative Insulin Sensitivity Check Index (QUICKI), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), atherogenic, thrombogenic, and lipophilic indices were calculated. Modified nutritionist IV software and the USDA composition table were used. Odds ratios (OR) and 95% confidence intervals (CI) were obtained using a case–control design. Age, BMI, energy in Model 1 and physical activity, blood glucose, level of insulin, lipid profile, creatinine level, and CRP were adjusted as interventions in Model 2. Compared to control subjects, patients with diabetic nephropathy (DN) had a significantly higher body mass index (BMI), level of fasting insulin, fasting blood sugar (FBS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and creatinine as well as lower intakes of energy, carbohydrates, mono—and polyunsaturated fatty acids, fiber, and cholesterol compared to controls. After adjustment for possible confounders, patients in the highest quartile of the atherogenic (OR: 3.49, 95% CI: 1.65–7.41), thrombogenic (OR: 4.3, 95% CI: 1.86–8.72), and lipophilic (OR: 3.50, 95% CI: 1.62–7.52) indices had significantly higher odds of DN than those in the lowest quartile. There was a considerable relationship between higher dietary fat indices (including atherogenic, thrombogenic, and lipophilic indices) and a higher chance of developing nephropathy.