Zhongguo quanke yixue (Jan 2023)
Effect of Impaired Fasting Glucose on Estimated Glomerular Filtration Rate
Abstract
Background Estimated glomerular filtration rate (eGFR) is a quantitative indicator assessing the severity of chronic kidney disease. Studies have shown that elevated glucose in prediabetic period increases the risk of chronic kidney disease, but its direct effect on eGFR has been less reported. Objective To investigate the effect of fasting blood glucose level on eGFR in a community-dwelling population with impaired fasting glucose (IFG) . Methods Participants (n=28 601) were selected from a group of physical examinees from Physical Examination Center, the Second Affiliated Hospital of Nanchang University during January to December 2020 according to the inclusion criteria and exclusion criteria. Demographic and clinical data〔past medical history, sex, age, BMI, blood pressure, serum uric acid, lipids, and creatinine, fasting plasma glucose (FPG) , routine urine parameters〕were collected and compared between subjects with elevated FPG (5.6 mmol/L≤FPG<7.0 mmol/L) and those with normal FPG (3.9 mmol/L≤FPG<5.6 mmol/L) . The influence of FPG on eGFR was assessed by the Mann-Whitney U-test comparing multiple factors〔sex, age, mean arterial pressure (MAP) , serum uric acid, total cholesterol, BMI〕 between subjects with elevated and normal FPG after matching. The correlation between FPG and eGFR was assessed in subjects with elevated and normal FPG before and after matching. Results There were 25 539 individuals with normal FPG, and 3 062 with elevated FPG. There were significant difference in age, MAP, serum uric acid, total cholesterol, BMI and eGFR between the two groups (P<0.05) . Individuals with elevated FPG had higher eGFR than those with normal eGFR (P<0.05) after matching age, MAP, serum uric acid, total cholesterol, and BMI between the two groups (P<0.05) . Correlation analysis showed that FPG had a weak negative correlation with eGFR in all participants (rs=-0.047, P<0.05) , but had a weak positive correlation with eGFR in the matched population (rs=0.065, P<0.05) , and the correlation coefficient increased further in the matched individuals with elevated FPG (rs=0.127, P<0.05) . Conclusion IFG may be associated with elevated eGFR, which provides a possible basis for the glomerular hyperfiltration state that occurs with elevated glucose in prediabetes.
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