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Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%

OBJECTIVE: To investigate whether fluctuations between the fasting and 2-h postload glucose ([2-hPBG]-fasting blood glucose [FBG]) states are associated with glomerular hyperfiltration (GHF) in middle-aged and elderly Chinese patients with newly diagnosed diabetes. DESIGN AND METHODS: In this study,...

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Autores principales: Hou, Xinguo, Wang, Chuan, Wang, Shaoyuan, Yang, Weifang, Ma, Zeqiang, Wang, Yulian, Li, Chengqiao, Li, Mei, Zhang, Xiuping, Zhao, Xiangmin, Sun, Yu, Song, Jun, Lin, Peng, Liang, Kai, Gong, Lei, Wang, Meijian, Liu, Fuqiang, Li, Wenjuan, Yan, Fei, Yang, Junpeng, Wang, Lingshu, Tian, Meng, Liu, Jidong, Zhao, Ruxing, Chen, Shihong, Chen, Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216006/
https://www.ncbi.nlm.nih.gov/pubmed/25360521
http://dx.doi.org/10.1371/journal.pone.0111173
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author Hou, Xinguo
Wang, Chuan
Wang, Shaoyuan
Yang, Weifang
Ma, Zeqiang
Wang, Yulian
Li, Chengqiao
Li, Mei
Zhang, Xiuping
Zhao, Xiangmin
Sun, Yu
Song, Jun
Lin, Peng
Liang, Kai
Gong, Lei
Wang, Meijian
Liu, Fuqiang
Li, Wenjuan
Yan, Fei
Yang, Junpeng
Wang, Lingshu
Tian, Meng
Liu, Jidong
Zhao, Ruxing
Chen, Shihong
Chen, Li
author_facet Hou, Xinguo
Wang, Chuan
Wang, Shaoyuan
Yang, Weifang
Ma, Zeqiang
Wang, Yulian
Li, Chengqiao
Li, Mei
Zhang, Xiuping
Zhao, Xiangmin
Sun, Yu
Song, Jun
Lin, Peng
Liang, Kai
Gong, Lei
Wang, Meijian
Liu, Fuqiang
Li, Wenjuan
Yan, Fei
Yang, Junpeng
Wang, Lingshu
Tian, Meng
Liu, Jidong
Zhao, Ruxing
Chen, Shihong
Chen, Li
author_sort Hou, Xinguo
collection PubMed
description OBJECTIVE: To investigate whether fluctuations between the fasting and 2-h postload glucose ([2-hPBG]-fasting blood glucose [FBG]) states are associated with glomerular hyperfiltration (GHF) in middle-aged and elderly Chinese patients with newly diagnosed diabetes. DESIGN AND METHODS: In this study, we included 679 newly diagnosed diabetes patients who were ≥40 years old. All the subjects were divided into two groups; those with HbA1c<7% and ≥7%. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate the glomerular filtration rate (GFR). GHF was defined as an eGFR ≥ the 90th percentile. First, a multiple linear regression analysis was used to estimate the association of 2-hPBG-FBG with eGFR. Then, a generalized additive model was used to explore the possible nonlinear relationship between 2-hPBG-FBG and eGFR. Next, the 2-hPBG-FBG values were divided into four groups as follows: 0–36, 36–72, 72–108 and ≥108 mg/dl. Finally, a multiple logistic regression analysis was used to investigate the association of 2-hPBG-FBG with the risk of GHF. RESULTS: For the group with HbA1c<7%, the eGFR and the percentage of GHF were significantly higher compared with the group with HbA1c≥7%. After adjusting for age, gender, body mass index (BMI), systolic blood pressure (BP), diastolic BP, fasting insulin, cholesterol, triglycerides, smoking, drinking and glycated hemoglobin (HbA1c), 2-hPBG-FBG was significantly associated with increased eGFR and an increased risk of GHF (the GHF risk increased by 64.9% for every 36.0 mg/dl [2.0 mmol/L] 2-hPBG-FBG increase) only in those patients with HbA1c<7%. Additionally, 2-hPBG-FBG and eGFR showed a nonlinear association (P<0.001). CONCLUSIONS: Increased fluctuations between the fasting and 2-h postload glucose states are closely associated with increased eGFR and an increased risk of GHF in newly diagnosed diabetes patients with HbA1c<7%.
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spelling pubmed-42160062014-11-05 Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7% Hou, Xinguo Wang, Chuan Wang, Shaoyuan Yang, Weifang Ma, Zeqiang Wang, Yulian Li, Chengqiao Li, Mei Zhang, Xiuping Zhao, Xiangmin Sun, Yu Song, Jun Lin, Peng Liang, Kai Gong, Lei Wang, Meijian Liu, Fuqiang Li, Wenjuan Yan, Fei Yang, Junpeng Wang, Lingshu Tian, Meng Liu, Jidong Zhao, Ruxing Chen, Shihong Chen, Li PLoS One Research Article OBJECTIVE: To investigate whether fluctuations between the fasting and 2-h postload glucose ([2-hPBG]-fasting blood glucose [FBG]) states are associated with glomerular hyperfiltration (GHF) in middle-aged and elderly Chinese patients with newly diagnosed diabetes. DESIGN AND METHODS: In this study, we included 679 newly diagnosed diabetes patients who were ≥40 years old. All the subjects were divided into two groups; those with HbA1c<7% and ≥7%. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to estimate the glomerular filtration rate (GFR). GHF was defined as an eGFR ≥ the 90th percentile. First, a multiple linear regression analysis was used to estimate the association of 2-hPBG-FBG with eGFR. Then, a generalized additive model was used to explore the possible nonlinear relationship between 2-hPBG-FBG and eGFR. Next, the 2-hPBG-FBG values were divided into four groups as follows: 0–36, 36–72, 72–108 and ≥108 mg/dl. Finally, a multiple logistic regression analysis was used to investigate the association of 2-hPBG-FBG with the risk of GHF. RESULTS: For the group with HbA1c<7%, the eGFR and the percentage of GHF were significantly higher compared with the group with HbA1c≥7%. After adjusting for age, gender, body mass index (BMI), systolic blood pressure (BP), diastolic BP, fasting insulin, cholesterol, triglycerides, smoking, drinking and glycated hemoglobin (HbA1c), 2-hPBG-FBG was significantly associated with increased eGFR and an increased risk of GHF (the GHF risk increased by 64.9% for every 36.0 mg/dl [2.0 mmol/L] 2-hPBG-FBG increase) only in those patients with HbA1c<7%. Additionally, 2-hPBG-FBG and eGFR showed a nonlinear association (P<0.001). CONCLUSIONS: Increased fluctuations between the fasting and 2-h postload glucose states are closely associated with increased eGFR and an increased risk of GHF in newly diagnosed diabetes patients with HbA1c<7%. Public Library of Science 2014-10-31 /pmc/articles/PMC4216006/ /pubmed/25360521 http://dx.doi.org/10.1371/journal.pone.0111173 Text en © 2014 Hou et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Hou, Xinguo
Wang, Chuan
Wang, Shaoyuan
Yang, Weifang
Ma, Zeqiang
Wang, Yulian
Li, Chengqiao
Li, Mei
Zhang, Xiuping
Zhao, Xiangmin
Sun, Yu
Song, Jun
Lin, Peng
Liang, Kai
Gong, Lei
Wang, Meijian
Liu, Fuqiang
Li, Wenjuan
Yan, Fei
Yang, Junpeng
Wang, Lingshu
Tian, Meng
Liu, Jidong
Zhao, Ruxing
Chen, Shihong
Chen, Li
Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%
title Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%
title_full Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%
title_fullStr Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%
title_full_unstemmed Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%
title_short Fluctuation between Fasting and 2-H Postload Glucose State Is Associated with Glomerular Hyperfiltration in Newly Diagnosed Diabetes Patients with HbA1c < 7%
title_sort fluctuation between fasting and 2-h postload glucose state is associated with glomerular hyperfiltration in newly diagnosed diabetes patients with hba1c < 7%
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216006/
https://www.ncbi.nlm.nih.gov/pubmed/25360521
http://dx.doi.org/10.1371/journal.pone.0111173
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