‘Yo-Yo Dieting’ Raises Kidney Disease Risk in T1D

TOPLINE:

Body weight variability or cycling, also known as “yo-yo dieting,” increases the risk for diabetic kidney disease (DKD) in patients with type 1 diabetes (T1D), independent of body mass index (BMI) and traditional risk factors.

METHODOLOGY:

• Body weight cycling, defined as the repeated loss and gain of weight over the years, has been associated with an increased risk for cardiovascular events in both the general population and patients with diabetes.
• Researchers evaluated the association between body weight cycling and DKD-related outcomes by conducting a retrospective analysis of data of 1432 patients with T1D from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications studies.
• They calculated four indices of intraindividual body weight variability using annual body weight data of the patients, choosing variability independent of the mean (VIM) as the primary index.
• Patients were monitored based on six criteria for kidney function decline and progression toward chronic kidney disease (CKD), including a 40% decline in the estimated glomerular filtration rate (eGFR), the doubling of baseline serum creatinine levels, and the development of stage III CKD.

TAKEAWAY:

• During an average follow-up of 21 years, a 40% decline in eGFR was observed in 18.8% of patients, whereas the doubling of baseline serum creatinine levels and progression to stage III CKD were observed in 8.6% and 8.9% of patients, respectively.
• Higher body weight variability, assessed using VIM, was significantly associated with a 40% decline in eGFR (hazard ratio [HR], 1.25; P = .001) and the doubling of baseline serum creatinine levels (HR, 1.34; P = .001).
• Patients with higher body weight variability had an increased risk for stage III CKD (HR, 1.36; P = .002) and a rapid decline in kidney function (HR, 1.49; P = .003).
• The relationship between higher body weight variability and worsened kidney function remained unaffected by BMI and other important confounding factors, including DKD risk factors and the use of nephroprotective medications throughout the follow-up period.

IN PRACTICE:

“Strategies aimed at weight reduction in people with type 1 diabetes should focus on promoting long-term weight maintenance, as weight stability may have a positive impact on health outcomes,” the authors wrote.

SOURCE:

This study was led by Marion Camoin, MD, Department of Endocrinology, Diabetes and Nutrition, Bordeaux University Hospital, Bordeaux, France. It was published online on February 4, 2025, in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The observational design of this study prevented conclusions about causal relationships between body weight cycling and outcomes. This study lacked information on the underlying causes of body weight variability. Statistical analyses of clinical endpoints were not adjusted for multiplicity due to statistical power considerations. Additionally, this retrospective analysis of a historical cohort with baseline data from 1983 may not have fully reflected current diabetes and DKD management practices.

DISCLOSURES:

This study did not receive any funding. The authors disclosed serving on advisory panels; receiving personal fees, consulting fees, honoraria, travel grants, nonfinancial support, and lecture fees; and having other ties with various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.