Glucose metabolism indices and the development of chronic kidney disease: a cohort study of middle-aged and elderly Chinese persons

作者：Lili You, 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 · 年份：2020 · DOI：10.22541/au.160029799.93563341 · 被引用次数：1 · 研究领域：Chronic Kidney Disease and Diabetes、Dialysis and Renal Disease Management、Parathyroid Disorders and Treatments

Background 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 This community-based population study included 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 ration (UACR) ≥30 mg/g. We examined the associations of glucose metabolism indices, including fasting plasma glucose (FPG), 2-hour (2h) oral glucose tolerance test (OGTT), haemoglobin 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 middl...