Glucose Metabolism Indices and the Development of Chronic Kidney Disease: A Cohort Study of Middle-Aged and Elderly Chinese Persons.

IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM
International Journal of Endocrinology Pub Date : 2023-08-02 eCollection Date: 2023-01-01 DOI:10.1155/2023/1412424
Lili You, Xiaosi Hong, Qiling Feng, Kan Sun, Diaozhu Lin, Chulin Huang, Chaogang Chen, Chuan Wang, Guojuan Lao, Shengneng Xue, Juying Tang, Na Li, Yiqin Qi, Wanting Feng, Feng Li, Chuan Yang, Mingtong Xu, Yan Li, Li Yan, Meng Ren
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引用次数: 0

Abstract

Objective: Chronic kidney disease (CKD) has become a major global health issue, and abnormalities of glucose metabolism are a risk factor responsible for development of CKD. We aimed to investigate associations between glucose metabolism indices and CKD in a Chinese population and determine which index is superior for predicting incident CKD.

Methods: We performed a community-based population on 5232 subjects aged ≥40 years without baseline CKD. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g. We examined the associations of glucose metabolism indices, including fasting plasma glucose (FPG), 2-hour (2 h) oral glucose tolerance test (OGTT), hemoglobin A1c (HbA1c), fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-β and the development of CKD.

Results: With an average follow-up of 3.6 years, 6.4% of the subjects developed CKD. Pearson's correlation analysis revealed that FPG, HbA1c, fasting insulin, and HOMA-IR were all significantly correlated with UACR and eGFR. The association persisted in multivariate linear regression analysis adjusted for age and sex. Compared with other glucose indices, HOMA-IR exhibited the strongest associations with CKD in COX multivariate regression analysis (HR = 1.17, 95% CI: 1.04-1.31).

Conclusion: HOMA-IR is superior to other routine indices of glucose metabolism for predicting the development of CKD in middle-aged Chinese persons. Screening with HOMA-IR may help prevent the development of CKD in the general population.

葡萄糖代谢指标与慢性肾脏病的发展:中国中老年人队列研究》。
目的:慢性肾脏病(CKD)已成为全球主要的健康问题,而糖代谢异常是导致CKD发生的危险因素之一。我们旨在研究中国人群中糖代谢指数与慢性肾脏病之间的关系,并确定哪种指数更适合预测慢性肾脏病的发生:方法:我们对 5232 名年龄≥40 岁、无基线 CKD 的受试者进行了社区人群研究。CKD的定义是估计肾小球滤过率(eGFR)2或尿白蛋白与肌酐比值(UACR)≥30 mg/g。我们研究了糖代谢指标,包括空腹血浆葡萄糖(FPG)、2 小时口服葡萄糖耐量试验(OGTT)、血红蛋白 A1c(HbA1c)、空腹胰岛素水平、胰岛素抵抗稳态模型评估(HOMA-IR)和 HOMA-β 与 CKD 发展的关系:结果:平均随访 3.6 年,6.4% 的受试者出现了慢性肾脏病。皮尔逊相关分析显示,FPG、HbA1c、空腹胰岛素和 HOMA-IR 均与 UACR 和 eGFR 显著相关。根据年龄和性别进行调整后,这种相关性在多变量线性回归分析中依然存在。与其他血糖指数相比,在 COX 多变量回归分析中,HOMA-IR 与 CKD 的相关性最强(HR = 1.17,95% CI:1.04-1.31):结论:HOMA-IR 在预测中国中年人的 CKD 发展方面优于其他常规糖代谢指标。使用 HOMA-IR 进行筛查有助于预防中年人患上 CKD。
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来源期刊
International Journal of Endocrinology
International Journal of Endocrinology ENDOCRINOLOGY & METABOLISM-
CiteScore
5.20
自引率
0.00%
发文量
147
审稿时长
1 months
期刊介绍: International Journal of Endocrinology is a peer-reviewed, Open Access journal that provides a forum for scientists and clinicians working in basic and translational research. The journal publishes original research articles, review articles, and clinical studies that provide insights into the endocrine system and its associated diseases at a genomic, molecular, biochemical and cellular level.
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