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Glucose metabolism indices and the development of chronic kidney disease: a cohort study of middle-aged and elderly Chinese persons
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  • Lili You,
  • Qiling Feng,
  • Kan Sun,
  • Diaozhu Lin,
  • Chulin Huang,
  • Chaogang Chen,
  • Chuan Wang,
  • Guojuan Lao,
  • Shengneng Xue,
  • Juying Tang,
  • Na Li,
  • Yiqin Qi,
  • Wanting Feng,
  • Feng Li,
  • Chuan Yang,
  • Mingtong Xu,
  • Yan Li,
  • Li Yan,
  • Meng Ren
Lili You
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Qiling Feng
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Kan Sun
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Diaozhu Lin
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Chulin Huang
Sun Yat-Sen Memorial Hospital
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Chaogang Chen
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Chuan Wang
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Guojuan Lao
Sun Yat-Sen Memorial Hospital
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Shengneng Xue
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Juying Tang
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Na Li
Sun Yat-Sen Memorial Hospital
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Yiqin Qi
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Wanting Feng
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Feng Li
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Chuan Yang
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Mingtong Xu
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Yan Li
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Li Yan
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Meng Ren
Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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Abstract

Background Chronic kidney disease (CKD) has become a major global health issue, and abnormalities of glucose metabolism are a risk factor responsible for development of CKD. We aimed to investigate associations between glucose metabolism indices and CKD in a Chinese population, and determine which index is superior for predicting incident CKD. Methods This community-based population study included 5232 subjects aged ≥40 years without baseline CKD. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or urinary albumin-to-creatinine ration (UACR) ≥30 mg/g. We examined the associations of glucose metabolism indices, including fasting plasma glucose (FPG), 2-hour (2h) oral glucose tolerance test (OGTT), haemoglobin A1c (HbA1c), fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA-β and the development of CKD. Results With an average follow-up of 3.6 years, 6.4% of the subjects developed CKD. Pearson’s correlation analysis revealed that FPG, HbA1c, fasting insulin, and HOMA-IR were all significantly correlated with UACR and eGFR. The association persisted in multivariate linear regression analysis adjusted for age and sex. Compared with other glucose indices, HOMA-IR exhibited the strongest associations with CKD in COX multivariate regression analysis (HR = 1.17, 95% CI: 1.04-1.31). Conclusion HOMA-IR is superior to other routine indices of glucose metabolism for predicting the development of CKD in middle-aged Chinese persons. Screening with HOMA-IR may help prevent the development of CKD in the general population.

Peer review status:IN REVISION

14 Sep 2020Submitted to International Journal of Clinical Practice
15 Sep 2020Assigned to Editor
15 Sep 2020Submission Checks Completed
25 Sep 2020Reviewer(s) Assigned
02 Nov 2020Review(s) Completed, Editorial Evaluation Pending
03 Nov 2020Editorial Decision: Revise Minor