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Prediabetes associated with CKD risk in middle-aged, older men
Among middle-aged and older Chinese men, prediabetes is associated with an increased risk for developing chronic kidney disease, according to an analysis of REACTION study data.
The researchers did not observe the same association among Chinese women, whereas diagnosed diabetes was independently associated with a higher risk for CKD in both sexes, according to the findings.
“The prevalence of diabetes among CKD patients was relatively high, whereas the awareness, treatment and control of diabetes was far from optimal, indicating the importance of glycemic control and early screening and treatment of hyperglycemia among CKD patients,” Weiqing Wang, MD, PhD, of the department of endocrine and metabolic diseases at Ruijin Hospital in Shanghai, and colleagues wrote.
Wang and colleagues analyzed data from 250,752 adults aged at least 40 years recruited from 2011 to 2012 for the REACTION study, a nationwide, prospective, observational study with follow-up at 3, 5 and 10 years (86,648 men; mean age, 57 years). All participants completed interviews and questionnaires and underwent a 75-g oral glucose tolerance test and provided fasting and a 2-hour OGTT; CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m². Within the cohort, 5,383 had CKD (2,205 men); 10.7% had previously diagnosed prediabetes; 10.8% had newly diagnosed diabetes; 25.8% had prediabetes and 52.7% had normal glucose tolerance.
Researchers found that the prevalence of CKD increased as glucose control deteriorated in men and women (P < .001 for trend).
In univariate logistic regression analysis, prediabetes, compared with normal glucose tolerance, was associated with CKD risk in both men and women. However, after adjustment for multiple factors, including age, BMI, physical activity, blood pressure, cholesterol and history of cardiovascular disease, the risk for CKD with prediabetes persisted only in men (OR = 1.15; 95% CI, 1.02-1.32). Compared with normal glucose tolerance, previously diagnosed diabetes increased the likelihood of CKD in both men (OR = 2.05; 95% CI, 1.78-2.35) and women (OR = 2.11; 95% CI, 1.88-2.37), as did newly diagnosed diabetes (OR for men = 1.27; 95% CI, 1.08-1.49; OR for women = 1.3; 95% CI, 1.13-1.49).
The researchers noted that the study included only middle-aged and older adults, and information was not collected regarding urinary protein, a known risk factor for kidney disease in the setting of diabetes.
“In addition, control of diabetes among Chinese CKD patients is far from optimal,” the researchers wrote. “Therefore, earlier detection and management efforts are needed for individuals with prediabetes to prevent the development, progression and complications of both diabetes and CKD.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.