Evaluation the Impacts of Body Mass Index and Waist Circumferences on Kidney Function Test of Diabetic Patients Treated in the Outpatient Clinics at King Hussein Medical Centre, Royal Medical Services, Jordan

Diabetic kidney disease (DKD) is a very a severe complication of diabetes associated with microvascular changes and reduction of glomerular filtration rate (GFR), it is also characterized by proteinuria (albuminuria) [1,2]. Up-40% of diabetic patients develop DKA [3]. Obesity is an increasing problem at international level and has been associated with health impacts [4]. Some epidemiological studies reported that the prevalence of overweight and obesity in adults of Taiwan reached approximately 44% [5]. BMI is an index describing both weight and height of a person to provide an approximation of a fat in the body. It is computed by dividing weight (kgs) by height (squared meters). According to BMI, a person can be: underweight (<18.5 kg/m2), normal weight (18.5 to 24.9 kg/m2), overweight (25 to 29.9 kg/m2), and obese (≥30 kg/m2) [6-8] Although body mass index (BMI) is considered as an acceptable measure for obesity categorization at international level, its accuracy in obesity has been questioned through several Received: September 19, 2019

studies [9][10][11]. It has been shown that men who have their WC ≥ 102 cm and women with WC ≥ 88 cm were more likely to be overweight.
WC between 94 to 102 cm in men, and 80-88 cm in women should be advised not to gain weight [12].

Study Objectives
The main objectives of the present study were to investigate the impacts of both BMI and WC on the clinical outcomes of kidney function tests.

Methods and Subjects
A retrospective study was conducted in which files of diabetic

Biochemical Profile of Study Participants
As shown in Table 2

The Relationship between BMI and Biochemical Profile of Study Participants
As demonstrated in Table 3, the relationships between BMI and biochemical tests were investigated using T test. There were strong relationships between BMI and variables included (p=0.000).

The Relationship between WC and Biochemical Profile of Study Participants
As illustrated in Table 4, the relationships between WC and biochemical tests were investigated using T test. There were strong relationships between WC and variables included (p=0.000).

The impact of BMI on biochemical tests among study participants
As shown in Table 5, there was a significant impact of BMI on all biochemical tests included among diabetic patients (p=0.000).

The Impact of WC on Biochemical Tests Among Study Participants (One Way Anova)
As it is demonstrated in Table 6, the impact of WC on biochemical tests among study participants with diabetes was investigated using One Way Anova. The results showed that WC significantly impacted all variables included (p<0.001), except potassium (p=0.216).

Discussion
The presented study investigated the impacts of both BMI and WC on renal function tests among diabetic patients. The mean level of BMI was about 32 kg/m 2 . WC mean level was about 98 cm.
these findings denoted that study participants were more likely to be obese as indicated by other studies [6][7][8]12]. In general terms, the present study showed that diabetic patients have disturbed profiles of kidney function tests including potassium levels and creatinine ( Table 2). This is in line with other studies in which abnormal kidney function tests were detected among diabetics [2,13]. The relationships between BMI and kidney function tests among diabetic patients were statistically significant (p=0.000, for all variables) ( Table 3). These findings indicated that obesity as reflected by BMI is a risk factor for developing abnormalities of renal function. These findings agree with previous studies [1,2,13].
The results of the present study showed that WC has significant relationships with all kidney function tests (p=0.000) as shown in Table 4. These results also confirmed that BMI and WC are both significant parameters for assessment of obesity. Previous studies showed the importance of WC in predicting obesity and predicting abnormal kidney function tests among diabetics [1,3]. Using One Way Anova test, we evaluated the impact of both BMI (Table 5), and WC (  [1,3,14]. These studies agreed that obesity, as measured by BMI or WC, is a significant predicting of both diabetes and alterations in kidney function tests.