Affiliation:
1. Diabetes Center, Aizawa Hospital , Matsumoto 3908510 , Japan
2. Department of Internal Medicine, Ina Central Hospital , Ina 3960033 , Japan
3. Kidney Disease and Hemodialysis Center, Aizawa Hospital , Matsumoto 3908510 , Japan
4. Health Center, Aizawa Hospital , Matsumoto 3908510 , Japan
Abstract
Abstract
Context
Chronic kidney disease (CKD) is a worldwide health problem. Recent literature has shown an association of hemoglobin glycation index (HGI) and CKD in patients with dysglycemia.
Objective
The aim of this study was to reveal the impact of HGI as a predictor for incident CKD in the general population.
Methods
CKD was defined as dipstick proteinuria or estimated glomerular rate (eGFR) < 60 mL/min/1.73 m2. Impact of HGI on incident CKD was assessed using the data from CKD-free health examinees (N = 23 467, 4.1% with diabetes) followed for a mean of 5.1 years: Cox proportional hazards model was employed with multivariate adjustment for age, systolic blood pressure, eGFR, fasting plasma glucose, body mass index, log[alanine aminotransferase], log[triglycerides], high-density lipoprotein cholesterol, platelet counts, smoking, and sex. Elevated level of HGI in subjects with CKD was ascertained after propensity score matching of another group of health examinees (N = 2580, 7.6% with diabetes).
Results
In the former group, CKD developed in 2540 subjects and HGI was the second most robust predictor for CKD, following low eGFR. With adjustment for the 11 covariates, the hazard ratio of HGI (95% CI) for CKD was 1.293 (1.238 to 1.349) (P < .0001). The population attributable risk of HGI for CKD was 4.2%. In the latter group, among 708 subjects matched 1:1 for 9 covariates, HGI was significantly elevated in subjects with CKD (median [interquartile range] −0.208 [−0.504 to −0.156] vs −0.284 [−0.582 to 0.052], P = .03).
Conclusion
HGI was a novel risk factor for CKD in the general population.
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism