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Interaction effect of blood glucose and pressure on the risk of chronic kidney disease: a population-based prospective cohort study

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Abstract

Objective

To evaluate the interaction effect of blood glucose and blood pressure on the risk of chronic kidney disease (CKD).

Methods

31,165 subjects were selected without CKD at baseline and had completed the first follow-up from “Jinchang cohort”. Cox regression model and restricted cubic splines functions were used to evaluate the effects of blood glucose or pressure on the incidence of CKD and dose-response relationship after adjusting for confounding covariates. Synergic effect was assessed by the multiplicative or additive interaction scale.

Results

Among 31,165 subjects, 1307 new-onset CKD were observed during 68905.78 person-years follow-up, and the incidence density was 18.97 per 1000 person-years. The risk of CKD gradually increased with the increase of blood pressure in diabetes, pre-diabetes and normal groups (Ptrend < 0.05). And, the risk was greatest when SBP/DBP reached ≥150/≥110 mmHg in three groups, and HRs (95% CI) were 1.610 (1.070–2.422), 2.142 (1.396–3.288) and 2.455 (1.941–3.106), respectively. Additionally, among hypertension, pre-hypertension and normal groups, the risk of CKD increased by 16.0%, 14.3% and 25.2% for each 1 mmol/L of FPG. When FPG level was more than 9.0 mmol/L, the risk was greatest and adjusted HRs (95% CI) were 2.856 (2.176–3.748), 2.979 (1.828–4.854) and 7.520 (4.517–12.519). Furthermore, the risk was highest when hypertension was accompanied by diabetes (HR = 4.915, 95% CI: 3.923–6.157). This analysis supported a less than multiplicative effect (HR = 0.634, 95% CI: 0.417–0.964) for the interaction term of diabetes and hypertension, while there was no additive interaction towards CKD in all interaction term.

Conclusions

Blood glucose and pressure were independent risk factors in incidence of CKD, but there was only a negative multiplicative interaction between hypertension and diabetes, but no additive interaction effect between them.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request and approval by the principal investigator.

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Acknowledgements

We thank all study participants and staff of the Worker’s Hospital of the Jinchuan Nonferrous Metals Corporation (JNMC) for their generous work, and the interviewers from the Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University.

Author contributions

The Software, formal analysis, investigation and writing-original draft: MX; conceptualization, methodology, writing-reviewing and editing, supervision: MW; formal analysis and investigation: HY, YZ, YH, JL, LZ; resources: DZ, CY; project administration, supervision: YB. All authors read and approved the final manuscript.

Funding

This study was supported by the National Natural Science Foundation of China (Grant Number: 41705122).

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Author notes

  1. These authors contributed equally: Minzhen Wang, Miao Xia

Authors and Affiliations

  1. Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China

    Minzhen Wang, Miao Xia, Hongyan Yang, Yanan Zhao, Yingqian He, Jing Liu, Lulu Zhang & Yana Bai

  2. Workers’ Hospital of Jinchuan Group Co, Ltd, Jinchang, 737100, Gansu, China

    Desheng Zhang & Chun Yin

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  1. Minzhen Wang
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Correspondence to Chun Yin or Yana Bai.

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This study was approved by the Ethics Committee of School of Public Health, Lanzhou University.

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Wang, M., Xia, M., Yang, H. et al. Interaction effect of blood glucose and pressure on the risk of chronic kidney disease: a population-based prospective cohort study. Endocrine 77, 252–261 (2022). https://doi.org/10.1007/s12020-022-03094-9

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  • DOI: https://doi.org/10.1007/s12020-022-03094-9

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