Abstract: Objective: To investigate the association between quantitative abdominal CT-based body composition characteristics and early diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study enrolled 298 patients with T2DM who visited Ningbo Hospital of Integrated Traditional Chinese and Western Medicine between January 2021 and June 2025. Patients were divided into an early DKD group (n=114) and a T2DM group without DKD (n=184). Body composition parameters at the L3 vertebral level were obtained using SliceOmatic software. Logistic regression analysis was performed to identify factors independently associated with early DKD, and subgroup and sensitivity analyses were conducted to evaluate the robustness of the associations. Results: Multivariate logistic regression demonstrated that skeletal muscle density (SMD, OR=0.91), T2DM duration (OR=1.08), and natural log-transformed C-reactive protein (ln CRP) (OR=1.55) were independently associated with early DKD. Subgroup analysis revealed significant effect modification by sex, age, and BMI on the association between SMD and early DKD (all P for interaction<0.05). Sensitivity analysis further corroborated the robustness of this association. Conclusion: Cross-sectional findings indicate that SMD is significantly associated with early DKD. However, its clinical value warrants further validation through prospective studies.

Key words:

type 2 diabetes mellitus, diabetic kidney disease, skeletal muscle density, body composition analysis, computed tomography, cross-sectional study