Glomerular Filtration Rate Trajectories in Patients with Type 2 Diabetes: Associated Factors in a Retrospective Cohort from Morocco

Glomerular Filtration Rate Trajectories in Patients with Type 2 Diabetes: Associated Factors in a Retrospective Cohort from Morocco | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Glomerular Filtration Rate Trajectories in Patients with Type 2 Diabetes: Associated Factors in a Retrospective Cohort from Morocco Asmae YEZNASNI, Mohammed Amine BOUAZZAOUI, Sanae SABBAR, Sara RAHHAOUI, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7321170/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Diabetic nephropathy is a leading cause of end-stage renal disease (ESRD) globally. In patients with type 2 diabetes mellitus (T2DM), early identification of glomerular filtration rate (GFR) decline trajectories may inform personalised prevention strategies. This study aimed to identify typical patterns of GFR progression and the modifiable risk factors associated with rapid decline in a Moroccan T2DM population. Methods We conducted a retrospective cohort study including 2,698 patients with T2DM. Demographic, clinical, and laboratory data were collected from structured follow-up forms. GFR trajectories were modelled using the cluster-based longitudinal modelling of distributions (clusterMLD) method. Multivariable logistic regression adjusted for age, sex, and diabetes duration was used to identify predictors of rapid GFR decline, with non-linear associations explored via restricted cubic splines. Results Two distinct GFR trajectories were identified: Cluster 1 (high baseline GFR with slow decline) and Cluster 2 (low baseline GFR with rapid decline). Cluster 2 patients were older, predominantly female, and exhibited higher rates of obesity, poor glycaemic control, and dyslipidaemia. In multivariable analysis, high HbA1c (> 12%), elevated body mass index (> 35 kg/m²), hypertriglyceridaemia (≥ 1.2 g/L), and low HDL-cholesterol (< 0.6 g/L) were independently associated with rapid GFR decline. Conclusion This study highlights the heterogeneity of kidney function trajectories among Moroccan patients with T2DM. Targeting modifiable risk factors such as poor glycaemic control, obesity, and dyslipidaemia may reduce the risk of rapid renal deterioration. Our findings support the need for early risk stratification and personalised intervention strategies to improve long-term renal outcomes in T2DM. Diabetic nephropathy type 2 diabetes mellitus glomerular filtration rate trajectories cohort Morocco Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7321170","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":511596206,"identity":"4b2e8924-9442-4864-bb6a-c0f2f4333db3","order_by":0,"name":"Asmae 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University","correspondingAuthor":false,"prefix":"","firstName":"Naima","middleName":"","lastName":"ABDA","suffix":""}],"badges":[],"createdAt":"2025-08-07 17:53:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7321170/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7321170/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93716192,"identity":"bc31fb1a-e6cc-48a7-b7bd-308648872c81","added_by":"auto","created_at":"2025-10-16 19:46:49","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":696923,"visible":true,"origin":"","legend":"","description":"","filename":"RevisedManuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7321170/v1_covered_95958547-e752-411d-8d99-26b725bef549.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Glomerular Filtration Rate Trajectories in Patients with Type 2 Diabetes: Associated Factors in a Retrospective Cohort from Morocco","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Diabetic nephropathy, type 2 diabetes mellitus, glomerular filtration rate, trajectories, cohort, Morocco","lastPublishedDoi":"10.21203/rs.3.rs-7321170/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7321170/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eDiabetic nephropathy is a leading cause of end-stage renal disease (ESRD) globally. In patients with type 2 diabetes mellitus (T2DM), early identification of glomerular filtration rate (GFR) decline trajectories may inform personalised prevention strategies. This study aimed to identify typical patterns of GFR progression and the modifiable risk factors associated with rapid decline in a Moroccan T2DM population.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe conducted a retrospective cohort study including 2,698 patients with T2DM. Demographic, clinical, and laboratory data were collected from structured follow-up forms. GFR trajectories were modelled using the cluster-based longitudinal modelling of distributions (clusterMLD) method. Multivariable logistic regression adjusted for age, sex, and diabetes duration was used to identify predictors of rapid GFR decline, with non-linear associations explored via restricted cubic splines.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eTwo distinct GFR trajectories were identified: Cluster 1 (high baseline GFR with slow decline) and Cluster 2 (low baseline GFR with rapid decline). Cluster 2 patients were older, predominantly female, and exhibited higher rates of obesity, poor glycaemic control, and dyslipidaemia. In multivariable analysis, high HbA1c (\u0026gt;\u0026thinsp;12%), elevated body mass index (\u0026gt;\u0026thinsp;35 kg/m\u0026sup2;), hypertriglyceridaemia (\u0026ge;\u0026thinsp;1.2 g/L), and low HDL-cholesterol (\u0026lt;\u0026thinsp;0.6 g/L) were independently associated with rapid GFR decline.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study highlights the heterogeneity of kidney function trajectories among Moroccan patients with T2DM. Targeting modifiable risk factors such as poor glycaemic control, obesity, and dyslipidaemia may reduce the risk of rapid renal deterioration. Our findings support the need for early risk stratification and personalised intervention strategies to improve long-term renal outcomes in T2DM.\u003c/p\u003e","manuscriptTitle":"Glomerular Filtration Rate Trajectories in Patients with Type 2 Diabetes: Associated Factors in a Retrospective Cohort from Morocco","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-10 19:40:42","doi":"10.21203/rs.3.rs-7321170/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"987f4de8-fd4a-446e-b533-2e59cba78872","owner":[],"postedDate":"September 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-16T19:38:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-10 19:40:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7321170","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7321170","identity":"rs-7321170","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}