title: Increased risk of glomerular hyperfiltration in subjects with impaired glucose tolerance and newly diagnosed diabetes.
abstract: Glomerular hyperfiltration is closely related to diabetes and may lead to subsequent nephropathy, but the association between glomerular hyperfiltration and prediabetic state is unclear. We examined the relationship of different glycemic statuses, including normal glucose tolerance (NGT), isolated impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and newly diagnosed diabetes (NDD), with glomerular hyperfiltration.
  
  
  
  This study included 12 833 subjects ≥20 years of age without a history of renal disease, cancer, moderate/severe anemia or diabetes and taking medications for hypertension, diabetes, hyperlipidemia or cardiovascular disease from National Cheng Kung University Hospital between January 2000 and August 2009. Hyperfiltration was defined as an estimated GFR (eGFR) above the age- and gender-specific 95th percentile for apparently healthy subjects, while hypofiltration was defined as an eGFR below the 5th percentile. eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation.
  
  
  
  After further excluding hypofiltration and adjusting for available confounders, fasting plasma glucose (FPG), 2-hour postload glucose (2hPG), 2hPG-FPG (fluctuating blood glucose), HbA1c (average blood glucose), NDD and IGT but not isolated IFG were significantly associated with increased eGFR and a higher risk of hyperfiltration {NDD: odds ratio [OR] 1.97 [95% confidence interval (CI), 1.48-2.64], P < 0.001; IGT: OR 1.34 (95% CI 1.07-1.66), P = 0.009}.
  
  
  
  High glucose states increase hyperfiltration risk. In addition to newly diagnosed diabetes, excessively high GFR also deserves attention in subjects with IGT.
authors.affiliation: Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
authors.forename: Zih-Jie
authors.initials: ZJ
authors.lastname: Sun
authors.affiliation: Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
authors.forename: Jin-Shang
authors.initials: JS
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China.
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Wang
authors.affiliation: Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan, Republic of China Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
authors.forename: Feng-Hwa
authors.initials: FH
authors.lastname: Lu
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose
keywords: chronic kidney disease; glomerular hyperfiltration; impaired fasting glucose; impaired glucose tolerance; prediabetes