title: HbA1c Levels Are Associated with Chronic Kidney Disease in a Non-Diabetic Adult Population: A Nationwide Survey (KNHANES 2011-2013).
abstract: 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.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Seok Hui
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Da Jung
authors.initials: DJ
authors.lastname: Jung
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Eun Woo
authors.initials: EW
authors.lastname: Choi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Kyu Hyang
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Do
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000652:urine; D044466:Asian People; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009749:Nutrition Surveys; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human