{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:23:46Z","timestamp":1782818626520,"version":"3.54.5"},"reference-count":34,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Natural Science Foundation of Shaanxi Province, China","award":["2023-JC-YB-742"],"award-info":[{"award-number":["2023-JC-YB-742"]}]},{"name":"Key Research and Development Project of Shaanxi Province","award":["2023-ZDLSF-40"],"award-info":[{"award-number":["2023-ZDLSF-40"]}]},{"name":"Innovation and Development Project of Tangdu Hospital, China","award":["2021SHRC046; 2021SHRC061; 2021SHRC007"],"award-info":[{"award-number":["2021SHRC046; 2021SHRC061; 2021SHRC007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>Diabetic kidney disease (DKD) is a common complication in patients with type 2 diabetes (T2DM), and early screening and diagnosis are crucial for preventing end-stage renal disease (ESRD). The extracellular water\/total body water (ECW\/TBW), as measured by bioelectrical impedance analysis (BIA), may be closely associated with the development of DKD. This study aimed to evaluate the relationship between ECW\/TBW and albuminuria in T2DM patients and to explore its potential as an early diagnostic tool.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Materials and methods<\/jats:title>\n               <jats:p>This study included 1,034 T2DM patients. Demographic information, medical history, medication use, and laboratory test results were collected, including glycated hemoglobin (HbA1c), creatinine, lipid profile, and the urine albumin-creatinine ratio (UACR). BIA was used to measure parameters such as ECW\/TBW. Multivariate logistic regression analysis explored the correlation between ECW\/TBW and UACR. Ultimately, two simple nomograms were established to predict macroalbuminuria from patients with normoalbuminuria and microalbuminuria, respectively.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>The ECW\/TBW increased significantly with rising UACR levels. Multivariate logistic regression analysis showed that ECW\/TBW was significantly associated with macroalbuminuria compared to both normo-albuminuria and microalbuminuria (OR = 2.082, 95% CI [1.476\u20132.937], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; and OR = 1.642, 95% CI [1.129\u20132.386], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009, respectively). In the analysis stratified by renal function, a similar relationship was found only in patients with eGFR \u2265 60 mL\/min\/1.73 m<jats:sup>2<\/jats:sup> (OR = 2.108, 95% CI [1.479\u20133.004], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) but not in patients with eGFR &lt;\u00a060\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>. Finally, two nomograms for predicting macroalbuminuria were established. The C-index of the nomogram model for predicting the macroalbuminuria in patients with normoalbuminuria was 0.795 (95% CI [0.752\u20130.838]), and the C-index of the nomogram model for predicting the macroalbuminuria in patients with microalbuminuria was 0.761 (95% CI [0.711\u20130.812]).<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusions<\/jats:title>\n               <jats:p>This study demonstrated a significant correlation between the ECW\/TBW and UACR levels in Chinese T2DM patients. In patients with normal or mildly impaired renal function (eGFR \u2265 60 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>), ECW\/TBW was significantly associated with macroalbuminuria, potentially serving as a diagnostic marker for macroalbuminuria.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.19780","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T08:41:24Z","timestamp":1753951284000},"page":"e19780","source":"Crossref","is-referenced-by-count":1,"title":["The association between the extracellular water-to-total body water ratio and albuminuria in Chinese type 2 diabetes mellitus patients"],"prefix":"10.7717","volume":"13","author":[{"given":"Aili","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi\u2019an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department 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