Kang Seok Hui, Jung Da Jung, Choi Eun Woo, Cho Kyu Hyang, Park Jong Won, Do Jun Young
Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
PLoS One. 2015 Dec 30;10(12):e0145827. doi: 10.1371/journal.pone.0145827. eCollection 2015.
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.
许多研究报告了非糖尿病患者糖化血红蛋白A1c（HbA1c）与代谢综合征（MetS）之间的关联。事实上，代谢综合征的每个组成部分都与慢性肾脏病（CKD）的发生和进展相关。因此，非糖尿病（DM）患者的HbA1c可能与慢性肾脏病的患病率存在内在关联。本研究的假设是，非糖尿病患者的高HbA1c与慢性肾脏病有关。
本研究的参与者总数为24594人。参与者根据其HbA1c水平分为三组：低水平组（<5.7%或<39 mmol/mol）、中等水平组（5.7 - 6.0%或39 - 42 mmol/mol）和高水平组（>6.0%或>42 mmol/mol）。使用慢性肾脏病流行病学协作方程计算估计肾小球滤过率（eGFR）。
分配到低水平组、中等水平组和高水平组的参与者人数分别为8651人、4634人和1387人。进行线性回归分析以评估变量之间的关联。腰围的标准化β±标准误差为0.25±0.22，空腹血糖为0.44±0.20，高密度脂蛋白胆固醇水平为 - 0.14±0.30，甘油三酯水平为0.15±2.31，收缩压为0.21±0.00，舒张压为0.10±0.00，eGFR为 - 0.22±0.42（所有变量P < 0.001）。非糖尿病参与者的eGFR与HbA1c水平呈负相关，即随着HbA1c水平升高，eGFR降低。多变量分析中的标准化β为 - 0.04±0.42（P < 0.001）。高水平组中仅患有代谢综合征、仅患有慢性肾脏病或同时患有代谢综合征和慢性肾脏病的参与者比例高于低水平组和中等水平组。
非糖尿病患者的高HbA1c可能与慢性肾脏病有关。可能需要监测高HbA1c水平患者的肾功能。
