title: Fasting blood glucose, but not 2-h postload blood glucose or HbA1c, is associated with mild decline in estimated glomerular filtration rate in healthy Chinese.
abstract: BACKGROUND
  The association of blood glucose [including fasting blood glucose (FBG), 2-h postload blood glucose, and glycated hemoglobin (HbA1c)] with the risk of a mild decline in the estimated glomerular filtration rate (eGFR) in healthy subjects was unclear. The aim of the study was to investigate this association in middle-aged and elderly healthy Chinese.
  
  
  METHODS
  The study included 1,112 healthy Chinese who were ≥40 years old, and all the subjects were divided into two groups based on FBG value of 5.6 mmol/L. A mildly reduced eGFR was defined as 60-90 mL/min/1.73 m2. Multiple linear or logistic regression analysis was used to estimate the association of blood glucose with eGFR and the risk of a mildly reduced eGFR, respectively. A generalized additive model was used to explore a possible nonlinear relationship between FBG and eGFR.
  
  
  RESULTS
  FBG was significantly associated with decreased eGFR and increased risk of a mildly reduced eGFR independent of age, gender, body mass index, waist circumference, systolic blood pressure (BP), diastolic BP, triglyceride, high-density lipoprotein cholesterol, fasting insulin, smoking, and drinking. Additionally, FBG and eGFR showed a nonlinear association (P<0.001). Interestingly, the group with FBG≥5.6 mmol/L significantly increased the risk of a mildly reduced eGFR (OR 2.06, P=0.001) after multivariable adjustment.
  
  
  CONCLUSIONS
  FBG is closely associated with decreased eGFR and increased risk of a mildly reduced eGFR. The ADA criteria using FBG=5.6 mmol/L instead of 6.1 mmol/L as cutoff point to define prediabetes are more suitable for the prevention of diabetes and related kidney disease.
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.forename: Chuan
authors.initials: C
authors.lastname: Wang
authors.forename: Weifang
authors.initials: W
authors.lastname: Yang
authors.forename: Yulian
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiuping
authors.initials: X
authors.lastname: Zhang
authors.forename: Zeqiang
authors.initials: Z
authors.lastname: Ma
authors.forename: Jun
authors.initials: J
authors.lastname: Song
authors.forename: Peng
authors.initials: P
authors.lastname: Lin
authors.forename: Kai
authors.initials: K
authors.lastname: Liang
authors.forename: Aixia
authors.initials: A
authors.lastname: Ma
authors.forename: Huizhen
authors.initials: H
authors.lastname: Zheng
authors.forename: Jiahui
authors.initials: J
authors.lastname: Wu
authors.forename: Lei
authors.initials: L
authors.lastname: Gong
authors.forename: Meijian
authors.initials: M
authors.lastname: Wang
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Liu
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Li
authors.forename: Fei
authors.initials: F
authors.lastname: Yan
authors.forename: Junpeng
authors.initials: J
authors.lastname: Yang
authors.forename: Lingshu
authors.initials: L
authors.lastname: Wang
authors.forename: Meng
authors.initials: M
authors.lastname: Tian
authors.forename: Jidong
authors.initials: J
authors.lastname: Liu
authors.forename: Ruxing
authors.initials: R
authors.lastname: Zhao
authors.forename: Xinguo
authors.initials: X
authors.lastname: Hou
authors.forename: Li
authors.initials: L
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002681:China; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism*; D064368:Healthy Volunteers; D006801:Humans; D007328:Insulin / Q000097:blood; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human