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Obesity is established as a risk factor of diabetes and chronic kidney disease and aggregates in families. This means that your genes can also increase your risk for (or help protect you from) diabetes, kidney disease or high blood pressure. A family history of these conditions in first-degree relative (a person’s parent, sibling, or child) could increase the risk even higher.

Obesity and diabetes are major causes of kidney diseases such as chronic kidney disease and end stage renal disease. Both obesity and diabetes, along with other metabolic syndromes such as hypertension are interlinked and contribute to the development and progression of kidney diseases.

Early intervention and weight management, and keeping a tab on blood sugar levels and blood pressure are necessary to reduce morbidity and mortality associated with both obesity-related and diabetes-related kidney disease.

Obesity and its risks

The number of obese adults is increasing rapidly in most countries. Health experts forecast that this rise in number could be a major cause of diseases such as type 2 diabetes, heart disease and cancer.

Also, obesity is no longer limited to older adults. Although the chances of obesity increase with age, it is alarming to see the increase in numbers young people and children.

Data from Public Health England suggests that nearly a third (31.2%) of children, aged 2 to 15 years, are obese.

Link between obesity and type 2 diabetes

It is not fully known about the cause of diabetes; however, its risk factors are well-known, this includes being overweight or obese i.e., having a body mass index (BMI) of 30 or greater.

Obesity is believed to be the reason for 80-85% of the cases of type 2 diabetes. Research suggests that obese people are up to 80 times more likely to develop type 2 diabetes, than those with a BMI of less than 22.

Being overweight or obese with having excess weight/fat around the abdominal region is a high-risk situation for diabetes to occur.

Some ways obesity causes type 2 diabetes are:

  • Inflammatory response: Abdominal fat causes fat cells to release pro-inflammatory chemicals, which can cause one’s body to be less sensitive or responsive to insulin. This could lead to, what is called as, insulin resistance – resulting in type 2 diabetes.
  • Disruption in fat metabolism: Obesity leads to changes in body’s metabolism. These changes can cause adipose (fat) tissue to release fat molecules into the blood, affecting insulin-responsive cells and leading to decreased insulin sensitivity.

How does obesity affect kidney disease?

It is known that diabetes and high blood pressure are the two main causes of kidney disease. However, being overweight can directly affect your kidneys, too. Extra weight forces the kidneys to work harder and filter wastes above the normal level. Over time, this extra work increases the risk for kidney disease.

Link between diabetes and kidney disease

Both type 1 and type 2 diabetes can cause kidney disease. Kidney diseases (chronic kidney disease – CKD) are one of the leading causes of death worldwide. In India, kidney disease was ranked eighth in place that led to lot of deaths.

Over time, poorly controlled diabetes can impair the accumulation of blood vessels in the kidneys that filter waste products from the blood. This can lead to kidney damage and high blood pressure. High blood pressure can cause further kidney damage by increasing pressure on the kidney’s delicate filtration system.

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FAQ's :

Those with a family history of obesity (who had higher BMI) can be at risk of developing obesity. Research suggests that about 35-40% of a child’s weight predisposition is inherited from their parents. In some cases of childhood obesity, the genetic impact may be as high as 55 to 60%.

Type 2 diabetes has a stronger link to family history and lineage than type 1. It is seen that genetics play a very strong role in the development of type 2 diabetes.

Kidney diseases are also known to run in families. Having a close relative with kidney disease increases your chances of developing kidney disease. Genes and lifestyle choices affect your health.
A family history of kidney disease is associated with an increased risk for end-stage renal disease (ESRD).
Examples of inherited kidney diseases are listed below:
•   Autosomal dominant polycystic kidney disease (ADPKD)
•   Alport syndrome
•   Cystinosis
•   Fabry disease
•   Gitelman syndrome
•   Nephronophthisis
•   Tuberous sclerosis complex (TSC)

Yes, there is a genetic test (Renasight) available to determine if there is increased risk of kidney disease due to family history or to establish if there is other genetic cause for an individual's kidney disease. The test uses a blood or saliva sample to test genes associated with kidney disease.

References:

  1. Obesity and diabetic kidney disease. The Medical Clinics of North America. https://pubmed.ncbi.nlm.nih.gov/23290730/ Accessed on 28-06-2022
  1. Diabesity: How Obesity Is Related to Diabetes. Diabetes and Endocrinology. Cleveland Clinic. https://health.clevelandclinic.org/diabesity-the-connection-between-obesity-and-diabetes/ Accessed on 28-06-2022
  1. Obesity and Diabetes. News Medical Life Sciences. https://www.news-medical.net/health/Obesity-and-Diabetes.aspx Accessed on 28-06-2022
  1. Diabetes and Obesity. Diabetes.co.uk https://www.diabetes.co.uk/diabetes-and-obesity.html Accessed on 28-06-2022

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