Abstract: PO0969
Cumulative Average and Variability of Blood Glucose, Blood Pressure, and Lipids Are Associated with Incidence of Albuminuria, but Not Reduced Kidney Function, Among Patients with Type 2 Diabetes
Session Information
- Diabetic Kidney Disease: Clinical - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Wang, Jinwei, Peking University First Hospital, Beijing, Beijing, China
- Zhang, Luxia, Peking University First Hospital, Beijing, China
- Zhao, Ming Hui, Peking University First Hospital, Beijing, China
Background
We evaluated the effect of cumulative average and variability of fasting blood glucose, blood pressure and lipids on the incidence of albuminuria and reduced estimated glomerular filtration rate (eGFR) among a population with diabetes.
Methods
The study was based on the Kailuan cohort in Tangshan of China. The study baseline was the 2014-2015 circle of health examination. Totally, 1569 patients with type 2 diabetes identified in the 2008-2009 circle, with participation of at least 3 circles of health examination (3-5 times) between 2008 and 2015, and with negative finding in dipstick test and a normal eGFR at baseline were included. The occurrence of albuminuria (urine albumin to creatinine ratio≥30mg/g) and eGFR<60ml/min/1.73m2 (with an absolute decline of >10%) was ascertained during 2016-2017. eGFR was determined with the CKD-EPI creatinine equation in the 2014-2015 circle and corresponding cystatin-C equation in the 2016-2017 circle. Cumulative average and intraindividual standard deviation (SD) of fasting blood glucose (FBG), systolic blood pressure (SBP), triglycerides and low-density lipoprotein cholesterol (LDL-C) were calculated. Multivariable logistic regression was used to estimate the association of the average and SD values of each variable with the events.
Results
The mean age of the population was 61.8±8.6 years, with a male dominance (77.6%). In the 2016-2017 circle, there were 499 events of albuminuria and 184 of reduced eGFR occurred. Cumulative average, but not SD of FBG, was significantly associated with incident albuminuria, with odds ratios (ORs) and 95% confidence interval of 1.20 (1.11-1.29) per 1 mmol/L increase. Both average and SD of SBP were associated with incident albuminuria with ORs of 1.17 (1.07-1.28) per 10 mmHg increase of average SBP and 1.16 (1.06-1.28) per 5 mmHg increase of SD of SBP. Triglycerides was associated with incident albuminuria with OR of 2.15(1.47-3.13) per one log-transformed value increase. However, no associations between the cumulative average and SDs of FBG, SBP, triglycerides and LDL-C and occurrence of reduced eGFR were found.
Conclusion
Cumulative exposure of FBG, SBP and triglycerides, as well as variability of SBP, could increase the risk of albuminuria among patients with type 2 diabetes.
Funding
- Government Support - Non-U.S.