Abstract P2126: Physical Activity, Inflammation, and Cardiometabolic Risk in Diabetic Kidney Disease: A Population-Based Study

Abstract

Introduction: Diabetic kidney disease (DKD) increases morbidity and mortality in individuals with diabetes. This study aimed to examine the relationships between cardiometabolic factors, high-sensitivity C-reactive protein (hs-CRP), physical activity (PA) measured as total METs, and the risk of DKD in adults. Additionally, it explored moderators of the association between total PA METs-DKD. Hypothesis: We hypothesized that lower levels of cardiometabolic factors and hs-CRP, along with higher levels of total PA METs are associated with reduced DKD risk in adults. We also posited that age and race/ethnicity moderate the relationship between total PA METs and DKD. Methods: The study analyzed 5,856 adults aged ≥18 years (mean age = 49.89) from the 2017-2018 National Health and Nutrition Examination Survey. DKD was defined by diabetes with an estimated glomerular filtration rate of <60 mL/min/1.73m2 or an albumin to creatinine ratio was ≥30 mg/g. The International Physical Activity Questionnaire was used to subjectively measure PA in the survey. Multiple imputations were conducted to address the missing data. Hierarchical logistic regression was used to assess the odds of DKD and identify moderators. Results: DKD was present in 13.32% of participants. Age strongly predicted DKD, with those aged 70-80 having an 18.13 times higher risk than those aged 20-29. Non-Hispanic Black participants had 1.51 times higher DKD risk than non-Hispanic Whites. Among metabolic and inflammatory markers, high systolic blood pressure, elevated fasting glucose level, and hs-CRP were associated with increased odds of DKD. Conversely, total cholesterol levels of 5.2-6.2 mmol/L and total PA METs ≥1,110 METs-minutes/week were linked to a 24% and 25% reduction in DKD odds, respectively. Age and race/ethnicity did not moderate the relationship between total PA METs and DKD. Conclusions: Most cardiometabolic markers and hs-CRP were associated with increased DKD risk, while total cholesterol and total PA METs were associated with reduced DKD risk. Contrary to our hypothesis, age and race/ethnicity did not moderate the relationship between total PA METs and DKD risk.