Cargando…
The association of glucose metabolism and kidney function in middle-aged adults
BACKGROUND: Previous clinical studies have shown that various measures of glucose metabolism are associated with a risk of chronic kidney disease in different populations, but results were not consistent. In this study we assessed measures of glucose metabolism and their association with kidney func...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572983/ https://www.ncbi.nlm.nih.gov/pubmed/34754434 http://dx.doi.org/10.1093/ckj/sfab074 |
_version_ | 1784595324458762240 |
---|---|
author | Schroijen, Marielle A de Mutsert, Renée Dekker, Friedo W de Vries, Aiko P J de Koning, Eelco J P Rabelink, Ton J Rosendaal, Frits R Dekkers, Olaf M |
author_facet | Schroijen, Marielle A de Mutsert, Renée Dekker, Friedo W de Vries, Aiko P J de Koning, Eelco J P Rabelink, Ton J Rosendaal, Frits R Dekkers, Olaf M |
author_sort | Schroijen, Marielle A |
collection | PubMed |
description | BACKGROUND: Previous clinical studies have shown that various measures of glucose metabolism are associated with a risk of chronic kidney disease in different populations, but results were not consistent. In this study we assessed measures of glucose metabolism and their association with kidney function in a population-based study. METHODS: The Netherlands Epidemiology of Obesity study is a population-based cohort study of middle-aged men and women. We categorized the study population according to glycaemic levels into normoglycaemia (reference group), pre-diabetes mellitus (pre-DM), known DM and newly diagnosed DM. Outcome variables were serum creatinine, estimated glomerular filtration rate (eGFR), glomerular hyperfiltration (defined as an eGFR >90th percentile; >102 mL/min/1.73 m(2)) and micro-albuminuria. We examined the association between measures of glucose metabolism [fasting glucose, haemoglobin A1c (HbA1c), fasting insulin, glucose area under the curve (AUC), insulin AUC, Homoeostatic Model Assessment of Insulin Resistance (HOMA-IR), HOMA of β-cell function (HOMA-B) and disposition index] and measures of kidney function. RESULTS: Of the total population (N = 6338), 55% of participants were classified as normoglycaemic (reference), 35% as pre-DM, 7% as DM and 4% as newly diagnosed DM. Compared with the reference group, diagnosed and newly diagnosed DMs were associated with a slightly higher trend in eGFR {+2.1 mL/min/1.73 m(2) [95% confidence interval (CI) −0.2–4.4] and +2.7 mL/min/1.73 m(2) [95% CI −0.3–5.7], respectively}. A 1% higher HbA1c was associated with increased odds of hyperfiltration [odds ratio (OR) 1.41 (95% CI 1.06–1.88)]. Higher levels of fasting plasma glucose, AUC glucose and HOMA-B were associated with hyperfiltration. Fasting insulin, AUC insulin and HOMA-IR were not associated with hyperfiltration. The OR of microalbuminuria was 1.21 (95% CI 1.04–1.42) per mmol/L higher fasting glucose concentrations. CONCLUSIONS: Both fasting and post-prandial glucose and HOMA-B, but not measures of insulin resistance, were associated with glomerular hyperfiltration, while fasting glucose was also associated with microalbuminuria. |
format | Online Article Text |
id | pubmed-8572983 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-85729832021-11-08 The association of glucose metabolism and kidney function in middle-aged adults Schroijen, Marielle A de Mutsert, Renée Dekker, Friedo W de Vries, Aiko P J de Koning, Eelco J P Rabelink, Ton J Rosendaal, Frits R Dekkers, Olaf M Clin Kidney J Original Article BACKGROUND: Previous clinical studies have shown that various measures of glucose metabolism are associated with a risk of chronic kidney disease in different populations, but results were not consistent. In this study we assessed measures of glucose metabolism and their association with kidney function in a population-based study. METHODS: The Netherlands Epidemiology of Obesity study is a population-based cohort study of middle-aged men and women. We categorized the study population according to glycaemic levels into normoglycaemia (reference group), pre-diabetes mellitus (pre-DM), known DM and newly diagnosed DM. Outcome variables were serum creatinine, estimated glomerular filtration rate (eGFR), glomerular hyperfiltration (defined as an eGFR >90th percentile; >102 mL/min/1.73 m(2)) and micro-albuminuria. We examined the association between measures of glucose metabolism [fasting glucose, haemoglobin A1c (HbA1c), fasting insulin, glucose area under the curve (AUC), insulin AUC, Homoeostatic Model Assessment of Insulin Resistance (HOMA-IR), HOMA of β-cell function (HOMA-B) and disposition index] and measures of kidney function. RESULTS: Of the total population (N = 6338), 55% of participants were classified as normoglycaemic (reference), 35% as pre-DM, 7% as DM and 4% as newly diagnosed DM. Compared with the reference group, diagnosed and newly diagnosed DMs were associated with a slightly higher trend in eGFR {+2.1 mL/min/1.73 m(2) [95% confidence interval (CI) −0.2–4.4] and +2.7 mL/min/1.73 m(2) [95% CI −0.3–5.7], respectively}. A 1% higher HbA1c was associated with increased odds of hyperfiltration [odds ratio (OR) 1.41 (95% CI 1.06–1.88)]. Higher levels of fasting plasma glucose, AUC glucose and HOMA-B were associated with hyperfiltration. Fasting insulin, AUC insulin and HOMA-IR were not associated with hyperfiltration. The OR of microalbuminuria was 1.21 (95% CI 1.04–1.42) per mmol/L higher fasting glucose concentrations. CONCLUSIONS: Both fasting and post-prandial glucose and HOMA-B, but not measures of insulin resistance, were associated with glomerular hyperfiltration, while fasting glucose was also associated with microalbuminuria. Oxford University Press 2021-04-05 /pmc/articles/PMC8572983/ /pubmed/34754434 http://dx.doi.org/10.1093/ckj/sfab074 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Schroijen, Marielle A de Mutsert, Renée Dekker, Friedo W de Vries, Aiko P J de Koning, Eelco J P Rabelink, Ton J Rosendaal, Frits R Dekkers, Olaf M The association of glucose metabolism and kidney function in middle-aged adults |
title | The association of glucose metabolism and kidney function in middle-aged adults |
title_full | The association of glucose metabolism and kidney function in middle-aged adults |
title_fullStr | The association of glucose metabolism and kidney function in middle-aged adults |
title_full_unstemmed | The association of glucose metabolism and kidney function in middle-aged adults |
title_short | The association of glucose metabolism and kidney function in middle-aged adults |
title_sort | association of glucose metabolism and kidney function in middle-aged adults |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572983/ https://www.ncbi.nlm.nih.gov/pubmed/34754434 http://dx.doi.org/10.1093/ckj/sfab074 |
work_keys_str_mv | AT schroijenmariellea theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT demutsertrenee theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT dekkerfriedow theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT devriesaikopj theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT dekoningeelcojp theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT rabelinktonj theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT rosendaalfritsr theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT dekkersolafm theassociationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT schroijenmariellea associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT demutsertrenee associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT dekkerfriedow associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT devriesaikopj associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT dekoningeelcojp associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT rabelinktonj associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT rosendaalfritsr associationofglucosemetabolismandkidneyfunctioninmiddleagedadults AT dekkersolafm associationofglucosemetabolismandkidneyfunctioninmiddleagedadults |