Abstract
Background
The association of blood glucose [including fasting blood glucose (FBG), 2-h postload blood glucose, and glycated hemoglobin (HbA1c)] with the risk of a mild decline in the estimated glomerular filtration rate (eGFR) in healthy subjects was unclear. The aim of the study was to investigate this association in middle-aged and elderly healthy Chinese.
Methods
The study included 1,112 healthy Chinese who were ≥40 years old, and all the subjects were divided into two groups based on FBG value of 5.6 mmol/L. A mildly reduced eGFR was defined as 60–90 mL/min/1.73 m2. Multiple linear or logistic regression analysis was used to estimate the association of blood glucose with eGFR and the risk of a mildly reduced eGFR, respectively. A generalized additive model was used to explore a possible nonlinear relationship between FBG and eGFR.
Results
FBG was significantly associated with decreased eGFR and increased risk of a mildly reduced eGFR independent of age, gender, body mass index, waist circumference, systolic blood pressure (BP), diastolic BP, triglyceride, high-density lipoprotein cholesterol, fasting insulin, smoking, and drinking. Additionally, FBG and eGFR showed a nonlinear association (P < 0.001). Interestingly, the group with FBG ≥5.6 mmol/L significantly increased the risk of a mildly reduced eGFR (OR 2.06, P = 0.001) after multivariable adjustment.
Conclusions
FBG is closely associated with decreased eGFR and increased risk of a mildly reduced eGFR. The ADA criteria using FBG = 5.6 mmol/L instead of 6.1 mmol/L as cutoff point to define prediabetes are more suitable for the prevention of diabetes and related kidney disease.
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Acknowledgments
This study was supported by Grants from the Chinese Society of Endocrinology, the National Natural Science Foundation of China (No. 81100617), the Medical and Health Science and Technology Development Projects of Shandong Province (2011HD005), the National Science and Technology Support Plan (2009BAI80B04), the Natural Science Foundation of Shandong Province (ZR2012HM014), the International Science and Technology Projects of Shandong Province (2012GGE27126), the Business Plan of Jinan Students Studying Abroad (20110407), and the special scientific research fund of clinical medicine of Chinese Medical Association (12030420342).
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The authors declare that they have no conflict of interest.
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Yu Sun and Chuan Wang have contributed equally to this work.
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Sun, Y., Wang, C., Yang, W. et al. Fasting blood glucose, but not 2-h postload blood glucose or HbA1c, is associated with mild decline in estimated glomerular filtration rate in healthy Chinese. Int Urol Nephrol 47, 147–152 (2015). https://doi.org/10.1007/s11255-014-0880-1
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DOI: https://doi.org/10.1007/s11255-014-0880-1