Association between a diabetes-predictive index and diabetes-related kidney disease in U.S. adults: A cross-sectional study.

Objective: This study aimed to investigate the association between Zhejiang University (ZJU) index and diabetic kidney disease (DKD) in U.S. adults.

Methods: We selected 13,549 U.S. adults aged 20 years or older from the National Health and Nutrition Examination Survey 2009-2020. The ZJU index is a composite score calculated by summing fasting plasma glucose, body mass index, triglycerides, and three times the alanine aminotransferase to aspartate aminotransferase ratio, with an additional 2 points for female subjects. DKD was defined by the presence of confirmed diabetes combined with a urine albumin-to-creatinine ratio ≥ 30 mg/g or an estimated glomerular filtration rate < 60 mL/min/1.73 m. We employed weighted multivariable logistic regression and sensitivity analyses to investigate the association between the ZJU index and DKD.

Results: The ZJU index is positively associated with DKD in U.S. adults. In adjusted model, the ZJU index showed a positive association with DKD (OR: 1.13, 95 % CI: 1.10, 1.16).

Conclusions: The findings suggest ZJU index's potential utility as a candidate metabolic marker associated with DKD. The ZJU index may serve as an auxiliary biomarker for DKD screening. However, due to the cross-sectional nature of the study, we cannot infer causal relationship between ZJU index and DKD.