Association between estimated glucose disposal rate and kidney function decline in different glucose tolerance statuses from the 4 C study.

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2024-12-18 DOI:10.1007/s00592-024-02432-9

Peiqiong Luo, Danpei Li, Yaming Guo, Xiaoyu Meng, Ranran Kan, Xuefeng Yu

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Abstract

Aims: To investigate the association between estimated glucose disposal rate (eGDR) and kidney function decline among populations with different glucose tolerance statuses including normal glucose tolerance (NGT), prediabetes, and diabetes.

Methods: The present study analyzed 5,069 participants from a cohort study. The association between eGDR and kidney function decline was assessed using binary logistic regression. Restricted cubic splines (RCS) analyses were also performed to investigate the dose-dependent associations.

Results: During up to 5 years of follow-up, 116 (2.30%) individuals experienced kidney function decline. Binary logistic regression showed that an increased level of eGDR was associated with decreased risk of kidney function decline after full adjustment, in all participants (Q4 vs. Q1 HR 0.13, 95% CI 0.05-0.30, p = 0.001), prediabetes (Q4 vs. Q1HR 0.11, 95% CI 0.01-0.44, p = 0.007), and diabetes (Q4 vs. Q1 HR 0.06, 95% CI 0.00-0.37, p = 0.012), but not in those with NGT. RCS analyses suggested dose-dependent relationships of eGDR with the risk of kidney function decline in all participants (L-shaped curve) and those with prediabetes (inverted U-shaped curve) and diabetes (L-shaped curve).

Conclusions: The association between elevated baseline eGDR and reduced risk of kidney function decline was significant in participants with prediabetes and diabetes, but not in those with NGT. These dose-dependent associations may have important implications for the assessment of high-risk patients by healthcare professionals and may lead to the development of more tailored and effective prevention strategies.

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4c研究中不同糖耐量状态下估计葡萄糖处置率与肾功能下降之间的关系

目的：探讨正常糖耐量（NGT）、糖尿病前期和糖尿病等不同糖耐量状态人群中葡萄糖处置率（eGDR）与肾功能下降的关系。方法：本研究分析了来自队列研究的5069名参与者。使用二元逻辑回归评估eGDR与肾功能下降之间的关系。限制性三次样条（RCS）分析也用于研究剂量依赖性关联。结果：在长达5年的随访中，116人（2.30%）出现肾功能下降。二元logistic回归显示，eGDR水平的升高与完全调整后肾功能下降的风险降低相关，在所有参与者中（Q4比Q1HR 0.13, 95% CI 0.05-0.30, p = 0.001）、前驱糖尿病（Q4比Q1HR 0.11, 95% CI 0.01-0.44, p = 0.007）和糖尿病（Q4比Q1HR 0.06, 95% CI 0.00-0.37, p = 0.012），但与NGT患者无关。RCS分析显示，eGDR与所有参与者（l型曲线）以及糖尿病前期（倒u型曲线）和糖尿病患者（l型曲线）的肾功能下降风险呈剂量依赖性关系。结论：基线eGDR升高与肾功能下降风险降低之间的关联在糖尿病前期和糖尿病患者中是显著的，但在NGT患者中没有。这些剂量依赖性关联可能对医疗保健专业人员对高危患者的评估具有重要意义，并可能导致制定更有针对性和更有效的预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.