HbA1c Levels Are Associated with Chronic Kidney Disease in a Non-Diabetic Adult Population: A Nationwide Survey (KNHANES 2011-2013).
HbA1c Levels Are Associated with Chronic Kidney Disease in a Non-Diabetic Adult Population: A Nationwide Survey (KNHANES 2011-2013).
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DOI：
10.1371/journal.pone.0145827
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Do JY
中科院分区：
文献类型：
--
作者：
Kang SH;Jung DJ;Choi EW;Cho KH;Park JW;Do JY
许多研究报道了非糖尿病患者糖化血红蛋白A1 c（HbA 1c）与代谢综合征（MetS）之间的相关性。MetS的每一个组成部分实际上都与慢性肾脏病（CKD）的发病率和进展有关。因此，非糖尿病（DM）患者的HbA 1c可能与CKD的患病率存在内在相关性。本研究的假设是，非DM患者的高HbA 1c与CKD相关。这项研究的参与者总数为24，594人。参与者根据他们的HbA 1c水平分为三组：低组（<5.7%或<39 mmol/mol），中组（5.7-6.0%或39-42 mmol/mol）和高组（>6.0%或>42 mmol/mol）。使用慢性肾脏病流行病学协作组公式计算估计的肾小球滤过率（eGFR）。分配到低、中和高组的参与者人数分别为8，651、4，634和1，387。进行线性回归分析，以评估变量之间的关联。腰围、空腹血糖、高密度脂蛋白胆固醇、甘油三酯、收缩压、舒张压的标准化β ±标准误分别为0.25 ± 0.22、0.44 ± 0.20、-0.14 ± 0.30、0.15 ± 2.31、0.21 ± 0.00、0.10 ± 0.00，eGFR为-0.22 ± 0.42（P < 0.001）。非糖尿病受试者的eGFR与HbA 1c水平呈负相关，其中eGFR随HbA 1c水平升高而降低。多因素分析标准化βs为-0.04 ± 0.42（P < 0.001）。高剂量组中仅患有MetS、仅患有CKD或MetS和CKD的参与者比例高于低剂量组和中剂量组。非DM患者的HbA 1c高可能与CKD相关。可能需要监测HbA 1c水平高的患者的肾功能。
Many studies have reported an association between glycated hemoglobin A1c (HbA1c) and metabolic syndrome (MetS) in non-diabetes patients. Each component of MetS is in fact related to chronic kidney disease (CKD) incidence and progression. Therefore, HbA1c in non-diabetic mellitus (DM) may be intrinsically associated with the prevalence of CKD. The hypothesis of the present study was that high HbA1c in non-DM patients is associated with CKD. The total number of participants in this study was 24,594. The participants were divided into three groups according to their HbA1c levels: a Low group (<5.7% or <39 mmol/mol), a Middle group (5.7–6.0% or 39–42 mmol/mol), and a High group (>6.0% or >42 mmol/mol). The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. The number of participants allocated to the Low, Middle, and High groups was 8,651, 4,634, and 1,387, respectively. Linear regression analyses were performed to evaluate the association between variables. Standardized β ± standard error was 0.25 ± 0.22 for waist circumference, 0.44 ± 0.20 for fasting glucose, –0.14 ± 0.30 for high-density lipoprotein cholesterol levels, 0.15 ± 2.31 for triglyceride levels, 0.21 ± 0.00 for systolic blood pressure, 0.10 ± 0.00 for diastolic blood pressure, and –0.22 ± 0.42 for eGFR (P < 0.001 for all variables). eGFR in non-diabetes participants was inversely associated with the HbA1c level, where eGFR decreased as HbA1c levels increased. Standardized βs were –0.04 ± 0.42 in multivariable analysis (P < 0.001). The proportion of participants with only MetS, only CKD, or both MetS and CKD was higher in the High group than in the Low and Middle groups. High HbA1c in non-DM patients may be associated with CKD. Renal function in patients with high HbA1c levels may need to be monitored.