Impact of Glucose Tolerance and Its Change on Incident Proteinuria: Analysis of a Nationwide Population-Based Dataset.

Autor:	Suzuki Y; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.; Department of Rehabilitation Science, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan., Kaneko H; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.; The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan., Okada A; Department of Prevention of Diabetes and Lifestyle-related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Itoh H; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Fujiu K; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.; The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan., Michihata N; The Department of Health Services Research, The University of Tokyo, Tokyo, Japan., Jo T; The Department of Health Services Research, The University of Tokyo, Tokyo, Japan., Takeda N; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Morita H; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Yamaguchi S; Department of Prevention of Diabetes and Lifestyle-related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Kamiya K; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan., Matsunaga A; Department of Rehabilitation Science, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan., Ako J; Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan., Node K; Department of Cardiovascular Medicine, Saga University, Saga, Japan., Yamauchi T; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Nangaku M; Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan., Yasunaga H; The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan., Komuro I; The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	American journal of nephrology [Am J Nephrol] 2022; Vol. 53 (4), pp. 307-315. Date of Electronic Publication: 2022 Mar 09.
DOI:	10.1159/000522280
Abstrakt:	Introduction: Although diabetes mellitus (DM) increases the risk of proteinuria, the relationship between prediabetes and proteinuria remains not fully understood. Further, whether the change in glucose is associated with the risk for proteinuria is unknown. Methods: This was a retrospective cohort study that included 1,849,074 participants (median age, 45 years; 59.3% men). No participants were taking glucose-lowering medications, and none had positive proteinuria at the initial health check-up. Each participant was categorized into three groups: normal (hemoglobin A1c [HbA1c] of <5.7%, n = 1,563,121), prediabetes (HbA1c of 5.7-6.4%, n = 253,490), and DM (HbA1c of ≥6.5%, n = 32,463) groups. We investigated the association between each HbA1c category and incident proteinuria using Cox proportional hazards models. We analyzed the association between the annual change in HbA1c and the risk for proteinuria. Results: A total of 65,954 participants developed proteinuria during the observation period. Not only DM (hazard ratio [HR]: 2.15, 95% confidence interval [CI]: 2.07-2.24) but also prediabetes (HR: 1.14, 95% CI: 1.12-1.17) was associated with a greater risk for proteinuria. The relative risk reduction for proteinuria that was associated with prediabetes and DM was 12.3% and 53.5%, respectively. An annual increase in HbA1c was associated with a greater risk for proteinuria. This association was more pronounced in participants having prediabetes. Conclusion: Not only DM but also prediabetes increased the risk for proteinuria. The influence of change in HbA1c on incident proteinuria was pronounced in people with prediabetes. Optimizing glucose would provide more benefit to individuals having prediabetes for proteinuria prevention. (© 2022 The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
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