{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T23:20:15Z","timestamp":1783552815178,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T00:00:00Z","timestamp":1606521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>Body fluid volume imbalance is common in patients with kidney failure, and is associated with all\u2010cause mortality. This study aimed to investigate the association between fluid volume imbalance and albuminuria in patients with type\u00a02 diabetes mellitus without kidney failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Using data from one cohort study, a baseline cross\u2010sectional study of 432 participants and a longitudinal cohort study of 368 participants who could follow up was carried out. Body fluid imbalance was determined by measuring the extracellular water (ECW)\u2010to\u2010intracellular water (ICW) ratio (ECW\/ICW) using bioelectrical impedance analysis. A change in the urinary albumin\u2010to\u2010creatinine ratio (ACR) was defined as the ratio of urinary ACR at follow up to that at baseline. The ECW\/ICW ratio was compared with the level of albuminuria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this cross\u2010sectional study, the ECW\/ICW ratio increased with the level of albuminuria. There was an association between the ECW\/ICW ratio and logarithms of urinary ACR after adjusting for covariates (\u03b2\u00a0=\u00a00.205, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Furthermore, the ECW\/ICW ratio was associated with a change in the urinary ACR after adjusting for covariates (\u03b2\u00a0=\u00a00.176, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) in this longitudinal study. According to the receiver operating characteristic curve, the optimal cut\u2010off point of the ECW\/ICW ratio for incident macroalbuminuria, defined as ACR &gt;300\u00a0mg\/gCr, was 0.648 (area under the curve 0.78, 95% confidence interval 0.58\u20130.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ECW\/ICW ratio is independently associated with the level of albuminuria in patients with type\u00a02 diabetes mellitus without kidney failure. This reinforces the importance of monitoring fluid balance in patients with type\u00a02 diabetes mellitus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13459","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T07:49:04Z","timestamp":1604476144000},"page":"1202-1211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Impact of extracellular\u2010to\u2010intracellular fluid volume ratio on albuminuria in patients with type\u00a02 diabetes: A cross\u2010sectional and longitudinal cohort study"],"prefix":"10.1111","volume":"12","author":[{"given":"Hanako","family":"Nakajima","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto 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