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Prediabetes is associated with microalbuminuria, reduced kidney function and chronic kidney disease in the general population: The KORA (Cooperative Health Research in the Augsburg Region) F4-Study.
Nutr Metab Cardiovasc Dis 2018; 28(3):234-242NM

Abstract

BACKGROUND AND AIMS

We investigated the associations of serum fasting (FG) and 2-h postload (2HG) glucose from an oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), fasting insulin and the homeostasis model assessment-insulin resistance index (HOMA-IR) with urinary albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR).

METHODS AND RESULTS

We performed cross-sectional analyses of 2713 subjects (1429 women; 52.7%) without known type 2 diabetes, aged 31-82 years, from the KORA (Cooperative Health Research in the Augsburg Region) F4-Study. FG, 2HG, HbA1c, fasting insulin, HOMA-IR and glucose tolerance categories were analyzed for association with ACR and eGFR in multivariable adjusted linear and median regression models, and with isolated microalbuminuria (i-MA), isolated reduced kidney function (i-RKF) and chronic kidney disease (CKD, defined as MA and/or RKF) in multivariable adjusted logistic regression models. Among the 2713 study participants, 28% revealed prediabetes (isolated impaired fasting glucose [i-IFG], isolated glucose tolerance [i-IGT] or both by American Diabetes Association definition), 4.2% had unknown type 2 diabetes, 6.5% had i-MA, 3.1% i-RKF and 10.9% CKD. In multivariable adjusted analysis, all continuous variables (FG, 2HG, HbA1c, fasting insulin and HOMA-IR) were associated with i-MA, i-RKF and CKD. The odds ratios (ORs) for i-MA and CKD were 1.54 (95% confidence interval: 1.02-2.33) and 1.58 (1.10-2.25) for individuals with i-IFG. Moreover, the OR for i-RKF was 2.57 (1.31-5.06) for individuals with IFG + IGT.

CONCLUSION

Our findings suggest that prediabetes might have harmful effects on the kidney.

Authors+Show Affiliations

Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany. Electronic address: marcello.markus@uni-greifswald.de.Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany; Chair of Epidemiology, Ludwig-Maximilians-University Munich, UNIKA-T Augsburg, Augsburg, Germany.German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany; Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.Institute for Psychology, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany; Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany.German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany.Chair of Epidemiology, Ludwig-Maximilians-University Munich, UNIKA-T Augsburg, Augsburg, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29337019

Citation

Markus, M R P., et al. "Prediabetes Is Associated With Microalbuminuria, Reduced Kidney Function and Chronic Kidney Disease in the General Population: the KORA (Cooperative Health Research in the Augsburg Region) F4-Study." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 28, no. 3, 2018, pp. 234-242.
Markus MRP, Ittermann T, Baumeister SE, et al. Prediabetes is associated with microalbuminuria, reduced kidney function and chronic kidney disease in the general population: The KORA (Cooperative Health Research in the Augsburg Region) F4-Study. Nutr Metab Cardiovasc Dis. 2018;28(3):234-242.
Markus, M. R. P., Ittermann, T., Baumeister, S. E., Huth, C., Thorand, B., Herder, C., ... Meisinger, C. (2018). Prediabetes is associated with microalbuminuria, reduced kidney function and chronic kidney disease in the general population: The KORA (Cooperative Health Research in the Augsburg Region) F4-Study. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 28(3), pp. 234-242. doi:10.1016/j.numecd.2017.12.005.
Markus MRP, et al. Prediabetes Is Associated With Microalbuminuria, Reduced Kidney Function and Chronic Kidney Disease in the General Population: the KORA (Cooperative Health Research in the Augsburg Region) F4-Study. Nutr Metab Cardiovasc Dis. 2018;28(3):234-242. PubMed PMID: 29337019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediabetes is associated with microalbuminuria, reduced kidney function and chronic kidney disease in the general population: The KORA (Cooperative Health Research in the Augsburg Region) F4-Study. AU - Markus,M R P, AU - Ittermann,T, AU - Baumeister,S E, AU - Huth,C, AU - Thorand,B, AU - Herder,C, AU - Roden,M, AU - Siewert-Markus,U, AU - Rathmann,W, AU - Koenig,W, AU - Dörr,M, AU - Völzke,H, AU - Schipf,S, AU - Meisinger,C, Y1 - 2017/12/22/ PY - 2017/08/09/received PY - 2017/11/21/revised PY - 2017/12/10/accepted PY - 2018/1/18/pubmed PY - 2019/3/15/medline PY - 2018/1/17/entrez KW - Albuminuria KW - Chronic kidney disease KW - Diabetes KW - Insulin resistance KW - Microalbuminuria SP - 234 EP - 242 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 28 IS - 3 N2 - BACKGROUND AND AIMS: We investigated the associations of serum fasting (FG) and 2-h postload (2HG) glucose from an oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), fasting insulin and the homeostasis model assessment-insulin resistance index (HOMA-IR) with urinary albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). METHODS AND RESULTS: We performed cross-sectional analyses of 2713 subjects (1429 women; 52.7%) without known type 2 diabetes, aged 31-82 years, from the KORA (Cooperative Health Research in the Augsburg Region) F4-Study. FG, 2HG, HbA1c, fasting insulin, HOMA-IR and glucose tolerance categories were analyzed for association with ACR and eGFR in multivariable adjusted linear and median regression models, and with isolated microalbuminuria (i-MA), isolated reduced kidney function (i-RKF) and chronic kidney disease (CKD, defined as MA and/or RKF) in multivariable adjusted logistic regression models. Among the 2713 study participants, 28% revealed prediabetes (isolated impaired fasting glucose [i-IFG], isolated glucose tolerance [i-IGT] or both by American Diabetes Association definition), 4.2% had unknown type 2 diabetes, 6.5% had i-MA, 3.1% i-RKF and 10.9% CKD. In multivariable adjusted analysis, all continuous variables (FG, 2HG, HbA1c, fasting insulin and HOMA-IR) were associated with i-MA, i-RKF and CKD. The odds ratios (ORs) for i-MA and CKD were 1.54 (95% confidence interval: 1.02-2.33) and 1.58 (1.10-2.25) for individuals with i-IFG. Moreover, the OR for i-RKF was 2.57 (1.31-5.06) for individuals with IFG + IGT. CONCLUSION: Our findings suggest that prediabetes might have harmful effects on the kidney. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/29337019/Prediabetes_is_associated_with_microalbuminuria_reduced_kidney_function_and_chronic_kidney_disease_in_the_general_population:_The_KORA__Cooperative_Health_Research_in_the_Augsburg_Region__F4_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(17)30319-8 DB - PRIME DP - Unbound Medicine ER -