The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients

作者：Lingwang An, Qiuzhi Yu, Linhui Chen, Hong Tang, Yanjun Liu, Qun Yuan, Yu Ji, Yaujiunn Lee, Juming Lu · 发表于：Frontiers in Endocrinology · 年份：2022 · DOI：10.3389/fendo.2021.723720 · 被引用次数：12 · 研究领域：Diabetes Treatment and Management、Chronic Kidney Disease and Diabetes、Diabetes Management and Research

Objective This study aimed to explore the relationship between short-term (≤12 months) changes in the estimated glomerular filtration rate (eGFR) and hemoglobin A 1c (HbA 1c ) in patients with type 2 diabetes (T2D). Method A total of 2,599 patients with T2D were enrolled if they were registered in the Diabetes Sharecare Information System, were aged 18–75 years, and had 2–3 HbA 1c and eGFR measurements within the preceding 12 months. The studied patients were categorized into five groups based on eGFR, i.e., the relatively stable (RS), fast decline (FD), modest decline (MD), modest increase (MI), and fast increase (FI) groups. Results The median eGFR changes from baseline were −22.14, −6.44, 0.00, 6.32, and 20.00 ml/min per 1.73 m 2 for patients in the FD, MD, RS, MI, and FI groups, respectively. Up to 1,153 (44.4%) subjects experienced an eGFR decline of ≥3.5 ml/min per 1.73 m 2 , including 821 (31.6%) FD subjects and 332 (12.8%) MD subjects. A decreased trend was found between the eGFR change and HbA 1c decrease category, even after multivariable adjustment. In general, an eGFR FD was frequently found in patients who had an HbA 1c reduction of ≥3.00% and a baseline HbA 1c ≥8.0%; alternatively, such a result was also observed for a urinary albumin-to-creatinine ratio (UACR) of 30.0–300.0 mg/g, regardless of a diabetes duration of <10.0 or ≥10.0 years, or in patients who had an HbA 1c reduction of ≥1.00% accompanied by hyperfiltration. Conclusions Some patients with T2...