{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:55:25Z","timestamp":1776401725895,"version":"3.51.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess whether overweight\/obesity accelerates proteinuria progression in patients with type 2 diabetes mellitus (T2DM) after coronavirus disease 2019 (COVID-19) infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 688 patients with T2DM confirmed to have COVID-19 infection and 502 pre-pandemic uninfected patients with T2DM for comparative analysis. Participants were categorized based on body mass index (BMI) into normal weight (BMI &amp;lt;24 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) and overweight\/obese (BMI \u226524 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) groups. Proteinuria progression, defined as an increase in albuminuria stage, was assessed within three months pre- and post-infection. Multiple logistic regression analysis was used to evaluate the association between body weight status and proteinuria progression after COVID-19 infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 688 infected participants, 8.5% experienced proteinuria progression. Within the infected cohort, the incidence of progression in the overweight\/obese group (10.8%) was significantly higher than in the normal weight group (4.9%, P = 0.012). Critically, the incidence of progression in the infected overweight\/obese group (10.8%) was also significantly higher than that in their uninfected overweight\/obese counterparts (5.8%, P = 0.016). In the COVID-19 infection cohort, overweight\/obese was associated with a 2.682-fold higher risk of proteinuria progression after COVID-19 infection compared to the normal weight group (OR, 2.682; 95%CI, 1.273-5.648; P = 0.009). Furthermore, every 1 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      increase in BMI was associated with a 13.1% increased risk of proteinuria progression after COVID-19 infection (OR, 1.131; 95% CI, 1.039 -1.23; P = 0.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overweight\/obese accelerates proteinuria progression in patients with T2DM following COVID-19 infection. Therefore, emphasizing the importance of obesity management is crucial to prevent renal complications in patients with T2DM after COVID-19.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1804593","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:15:38Z","timestamp":1776399338000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Overweight\/obesity accelerates proteinuria progression in type 2 diabetes post-COVID-19: a comparison with a pre-pandemic uninfected cohort"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiajun","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liping","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin","family":"Zhen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yizhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"University of Shanghai for Science and Technology","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongcheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"University of Shanghai for Science and Technology","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yizhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoying","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00459-7","article-title":"Characteristics of SARS-coV-2 and COVID-19","volume":"19","author":"Hu","year":"2021","journal-title":"Nat Rev Microbiol"},{"key":"B2","unstructured":"Coronavirous disease (COVID-19) pandemic"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"Jama"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2020030276","article-title":"Renal involvement and early prognosis in patients with COVID-19 pneumonia","volume":"31","author":"Pei","year":"2020","journal-title":"J Am Soc Nephrol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.50014","article-title":"Kidney function decline after COVID-19 infection","volume":"7","author":"Mahalingasivam","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.00580111","article-title":"Albuminuria and estimated glomerular filtration rate as predictors of diabetic end-stage renal disease and death","volume":"6","author":"Berhane","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.111021","article-title":"Effect of weight loss on proteinuria in adults with type 2 diabetes: A real-world study","volume":"206","author":"Ren","year":"2023","journal-title":"Diabetes Res Clin Pract"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-11-201306040-00007","article-title":"Evaluation and management of chronic kidney disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline","volume":"158","author":"Stevens","year":"2013","journal-title":"Ann Internal Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1046\/j.1440-6047.11.s8.9.x","article-title":"Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults","volume":"15","author":"Zhou","year":"2002","journal-title":"BioMed Environ Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.6.1487","article-title":"Use and abuse of HOMA modeling","volume":"27","author":"Wallace","year":"2004","journal-title":"Diabetes Care"},{"key":"B12","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3760\/cma.j.issn.1673-4157.2002.04.026","article-title":"Status of insulin resistance in Chinese population","volume":"22","author":"W","year":"2002","journal-title":"Int J Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney Int"},{"key":"B14","unstructured":"Living guidance for clinical management of COVID-19: living guidance\n          \n          \n          \n          2021"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.04.002","article-title":"Collapsing glomerulopathy in a patient with COVID-19","volume":"5","author":"Larsen","year":"2020","journal-title":"Kidney Int Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.04.003","article-title":"Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China","volume":"98","author":"Su","year":"2020","journal-title":"Kidney Int"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.03.005","article-title":"Kidney disease is associated with in-hospital death of patients with COVID-19","volume":"97","author":"Cheng","year":"2020","journal-title":"Kidney Int"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241953","article-title":"Incidence and risk factors of kidney impairment on patients with COVID-19: A meta-analysis of 10180 patients","volume":"15","author":"Yang","year":"2020","journal-title":"PloS One"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfad121","article-title":"Long-term effect of COVID-19 infection on kidney function among COVID-19 patients followed in post-COVID-19 recovery clinics in British Columbia, Canada","volume":"38","author":"Atiquzzaman","year":"2023","journal-title":"Nephrol Dialysis Transplant"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfad008","article-title":"Kidney outcome after mild to moderate COVID-19","volume":"38","author":"Schmidt-Lauber","year":"2023","journal-title":"Nephrol Dial Transplant"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2024.2365979","article-title":"Construction and validation of a risk model of proteinuria in patients with omicron COVID-19: retrospective cohort study","volume":"46","author":"Teng","year":"2024","journal-title":"Ren Fail"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms13051008","article-title":"Increased measured GFR and proteinuria in children with previous infection by SARS-CoV-2: Should we be concerned","volume":"13","author":"Marcellino","year":"2025","journal-title":"Microorganisms"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01909-w","article-title":"Symptoms and risk factors for long COVID in non-hospitalized adults","volume":"28","author":"Subramanian","year":"2022","journal-title":"Nat Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1089\/jwh.2020.8974","article-title":"Sex-based differences in COVID-19 outcomes","volume":"30","author":"Tejpal","year":"2021","journal-title":"J Womens Health (Larchmt)"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.09.021","article-title":"Prevalence and associations of moderately increased albuminuria in patients with type 2 diabetes in United Arab Emirates","volume":"14","author":"Arman Rabbani","year":"2020","journal-title":"Diabetes Metab Syndrome: Clin Res Rev"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1804593\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:15:43Z","timestamp":1776399343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1804593\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":25,"alternative-id":["10.3389\/fendo.2026.1804593"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1804593","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"article-number":"1804593"}}