Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults

BACKGROUND AND OBJECTIVE: Diabetes is a strong risk factor for cardiovascular diseases, whereas few studies have investigated simultaneously the associations of glycated haemoglobin A1c (HbA1c), fasting blood glucose (fasting plasma glucose (FPG)) and 2 h postload blood glucose (2 h PG) with low-gra...

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Autores principales: Huang, Xiaolin, Zhou, Yulin, Xu, Baihui, Sun, Wanwan, Lin, Lin, Sun, Jichao, Xu, Min, Lu, Jieli, Bi, Yufang, Wang, Weiqing, Xu, Yu, Ning, Guang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538277/
https://www.ncbi.nlm.nih.gov/pubmed/26243552
http://dx.doi.org/10.1136/bmjopen-2014-007429
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author Huang, Xiaolin
Zhou, Yulin
Xu, Baihui
Sun, Wanwan
Lin, Lin
Sun, Jichao
Xu, Min
Lu, Jieli
Bi, Yufang
Wang, Weiqing
Xu, Yu
Ning, Guang
author_facet Huang, Xiaolin
Zhou, Yulin
Xu, Baihui
Sun, Wanwan
Lin, Lin
Sun, Jichao
Xu, Min
Lu, Jieli
Bi, Yufang
Wang, Weiqing
Xu, Yu
Ning, Guang
author_sort Huang, Xiaolin
collection PubMed
description BACKGROUND AND OBJECTIVE: Diabetes is a strong risk factor for cardiovascular diseases, whereas few studies have investigated simultaneously the associations of glycated haemoglobin A1c (HbA1c), fasting blood glucose (fasting plasma glucose (FPG)) and 2 h postload blood glucose (2 h PG) with low-grade albuminuria, which is an earlier marker of cardiovascular diseases in the general population. Our study aimed to investigate and compare associations of HbA1c, FPG, and 2 h PG levels with risks of low-grade albuminuria in the middle-aged and elderly Chinese. DESIGN AND METHODS: This was a cross-sectional study involving 9188 participants aged 40 years or older. All participants underwent a standard 75 g oral glucose tolerance test. Low-grade albuminuria was defined as the highest quartile of urinary albumin-to-creatinine ratio (ACR) (>6.10 mg/g in males and >8.76 mg/g in females) in respondents without microalbuminuria or macroalbuminuria. RESULTS: HbA1c, FPG and 2 h PG were all significantly correlated with urinary ACR after adjustment for confounders (all p values <0.0001). After adjustment for HbA1c, the relationships of FPG and 2 h PG with ACR reduced to null. HbA1c levels were still significantly associated with ACR after further adjustment for FPG and 2 h PG. Multiple logistic regression showed that risks of low-grade albuminuria were positively associated with HbA1c levels in a dose–response manner. Compared with participants with HbA1c ≤37 mmol/mol (5.5%), ORs (95% CIs) for low-grade albuminuria were 1.05 (0.94 to 1.18), 1.25 (1.04 to 1.50), 1.40 (1.04 to 1.90) and 2.21 (1.61 to 3.03) for HbA1c categories of 38–42 mmol/mol (5.6–6.0%), 43–48 mmol/mol (6.1–6.5%), 49–53 mmol/mol (6.6–7.0%), and >53 mmol/mol (7.0%), respectively (p(for trend) <0.0001). CONCLUSIONS: HbA1c, but not FPG or 2 h PG, was independently associated with an increased risk of low-grade albuminuria in the middle-aged and elderly Chinese.
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spelling pubmed-45382772015-08-21 Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults Huang, Xiaolin Zhou, Yulin Xu, Baihui Sun, Wanwan Lin, Lin Sun, Jichao Xu, Min Lu, Jieli Bi, Yufang Wang, Weiqing Xu, Yu Ning, Guang BMJ Open Diabetes and Endocrinology BACKGROUND AND OBJECTIVE: Diabetes is a strong risk factor for cardiovascular diseases, whereas few studies have investigated simultaneously the associations of glycated haemoglobin A1c (HbA1c), fasting blood glucose (fasting plasma glucose (FPG)) and 2 h postload blood glucose (2 h PG) with low-grade albuminuria, which is an earlier marker of cardiovascular diseases in the general population. Our study aimed to investigate and compare associations of HbA1c, FPG, and 2 h PG levels with risks of low-grade albuminuria in the middle-aged and elderly Chinese. DESIGN AND METHODS: This was a cross-sectional study involving 9188 participants aged 40 years or older. All participants underwent a standard 75 g oral glucose tolerance test. Low-grade albuminuria was defined as the highest quartile of urinary albumin-to-creatinine ratio (ACR) (>6.10 mg/g in males and >8.76 mg/g in females) in respondents without microalbuminuria or macroalbuminuria. RESULTS: HbA1c, FPG and 2 h PG were all significantly correlated with urinary ACR after adjustment for confounders (all p values <0.0001). After adjustment for HbA1c, the relationships of FPG and 2 h PG with ACR reduced to null. HbA1c levels were still significantly associated with ACR after further adjustment for FPG and 2 h PG. Multiple logistic regression showed that risks of low-grade albuminuria were positively associated with HbA1c levels in a dose–response manner. Compared with participants with HbA1c ≤37 mmol/mol (5.5%), ORs (95% CIs) for low-grade albuminuria were 1.05 (0.94 to 1.18), 1.25 (1.04 to 1.50), 1.40 (1.04 to 1.90) and 2.21 (1.61 to 3.03) for HbA1c categories of 38–42 mmol/mol (5.6–6.0%), 43–48 mmol/mol (6.1–6.5%), 49–53 mmol/mol (6.6–7.0%), and >53 mmol/mol (7.0%), respectively (p(for trend) <0.0001). CONCLUSIONS: HbA1c, but not FPG or 2 h PG, was independently associated with an increased risk of low-grade albuminuria in the middle-aged and elderly Chinese. BMJ Publishing Group 2015-08-04 /pmc/articles/PMC4538277/ /pubmed/26243552 http://dx.doi.org/10.1136/bmjopen-2014-007429 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Diabetes and Endocrinology
Huang, Xiaolin
Zhou, Yulin
Xu, Baihui
Sun, Wanwan
Lin, Lin
Sun, Jichao
Xu, Min
Lu, Jieli
Bi, Yufang
Wang, Weiqing
Xu, Yu
Ning, Guang
Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults
title Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults
title_full Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults
title_fullStr Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults
title_full_unstemmed Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults
title_short Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults
title_sort glycated haemoglobin a1c is associated with low-grade albuminuria in chinese adults
topic Diabetes and Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538277/
https://www.ncbi.nlm.nih.gov/pubmed/26243552
http://dx.doi.org/10.1136/bmjopen-2014-007429
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