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Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults.

Huang X, Zhou Y, Xu B, Sun W, Lin L, Sun J, Xu M, Lu J, Bi Y, Wang W, Xu Y, Ning G - BMJ Open (2015)

Bottom Line: This was a cross-sectional study involving 9188 participants aged 40 years or older.All participants underwent a standard 75 g oral glucose tolerance test.Low-grade albuminuria was defined as the highest quartile of urinary albumin-to-creatinine ratio (ACR) (>6.10 mg/g in males and >8.76 mg/g in females) in respondents without microalbuminuria or macroalbuminuria.

View Article: PubMed Central - PubMed

Affiliation: Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai, China Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.

No MeSH data available.


Related in: MedlinePlus

Adjusted ORs of low-grade albuminuria associated with each 5.5 mmol/mol (0.5%) increase in HbA1c in subgroups. All models were adjusted for potential confounding factors including sex (except for sex strata), age, smoking status (except for current smoker strata), drinking status (except for current drinker strata), physical activity (except for physical activity strata), BMI, TG, HDL-c, LDL-c, SBP, use of ACEI/ARB drugs (except for use of ACEI/ARB drugs strata), use of antidiabetic drugs (except for use of antidiabetic drugs strata), eGFR, FPG and 2 h PG. aData were analysed with further adjustment for duration of diabetes. bData were analysed in individuals with diabetes, including those newly diagnosed and those who have been previously diagnosed. (2 h PG, 2 h postload glucose; ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; FPG, fasting plasma glucose; eGFR, estimated glomerular filtration rate; HbA1c, glycated haemoglobin A1c; HDL-c, high-density lipoprotein cholesterol; LDL-c, low-density lipoprotein cholesterol; SBP, systolic blood pressure; TG, triglyceride).
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BMJOPEN2014007429F2: Adjusted ORs of low-grade albuminuria associated with each 5.5 mmol/mol (0.5%) increase in HbA1c in subgroups. All models were adjusted for potential confounding factors including sex (except for sex strata), age, smoking status (except for current smoker strata), drinking status (except for current drinker strata), physical activity (except for physical activity strata), BMI, TG, HDL-c, LDL-c, SBP, use of ACEI/ARB drugs (except for use of ACEI/ARB drugs strata), use of antidiabetic drugs (except for use of antidiabetic drugs strata), eGFR, FPG and 2 h PG. aData were analysed with further adjustment for duration of diabetes. bData were analysed in individuals with diabetes, including those newly diagnosed and those who have been previously diagnosed. (2 h PG, 2 h postload glucose; ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; FPG, fasting plasma glucose; eGFR, estimated glomerular filtration rate; HbA1c, glycated haemoglobin A1c; HDL-c, high-density lipoprotein cholesterol; LDL-c, low-density lipoprotein cholesterol; SBP, systolic blood pressure; TG, triglyceride).

Mentions: Using participants with HbA1c≤37 mmol/mol (5.5%) as the reference group, a dose–response relationship was found between HbA1c levels and risks of low-grade albuminuria (table 3). Although the magnitude of association was decreased after adjustment for confounding factors, it remained significant, especially for groups with higher HbA1c levels. Further adjustment for FPG and 2 h PG caused little change and the dose–response relationship still remained (ORs were 1.00, 1.05, 1.25, 1.40 and 2.21 for HbA1c categories of ≤37 mmol/mol (5.5%), 38–42 mmol/mol (5.6–6.0%), 43–48 mmol/mol (6.1–6.5%), 49–53 mmol/mol (6.6–7.0%) and >53 mmol/mol (7.0%), respectively; pfor trend <0.0001, table 3). The association between low-grade albuminuria and HbA1c was fairly consistent among subgroups (p values for interaction >0.05), except for the subgroup of obesity (p value for interaction=0.033; figure 2). Moreover, the receiver operating characteristic curve (ROC) analysis revealed that the area under the curve was 0.58 (0.56–0.59) and the optimal cut-off value of HbA1c for low-grade albuminuria was 39 mmol/mol (5.7%) with the largest Youden Index.


Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults.

Huang X, Zhou Y, Xu B, Sun W, Lin L, Sun J, Xu M, Lu J, Bi Y, Wang W, Xu Y, Ning G - BMJ Open (2015)

Adjusted ORs of low-grade albuminuria associated with each 5.5 mmol/mol (0.5%) increase in HbA1c in subgroups. All models were adjusted for potential confounding factors including sex (except for sex strata), age, smoking status (except for current smoker strata), drinking status (except for current drinker strata), physical activity (except for physical activity strata), BMI, TG, HDL-c, LDL-c, SBP, use of ACEI/ARB drugs (except for use of ACEI/ARB drugs strata), use of antidiabetic drugs (except for use of antidiabetic drugs strata), eGFR, FPG and 2 h PG. aData were analysed with further adjustment for duration of diabetes. bData were analysed in individuals with diabetes, including those newly diagnosed and those who have been previously diagnosed. (2 h PG, 2 h postload glucose; ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; FPG, fasting plasma glucose; eGFR, estimated glomerular filtration rate; HbA1c, glycated haemoglobin A1c; HDL-c, high-density lipoprotein cholesterol; LDL-c, low-density lipoprotein cholesterol; SBP, systolic blood pressure; TG, triglyceride).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4538277&req=5

BMJOPEN2014007429F2: Adjusted ORs of low-grade albuminuria associated with each 5.5 mmol/mol (0.5%) increase in HbA1c in subgroups. All models were adjusted for potential confounding factors including sex (except for sex strata), age, smoking status (except for current smoker strata), drinking status (except for current drinker strata), physical activity (except for physical activity strata), BMI, TG, HDL-c, LDL-c, SBP, use of ACEI/ARB drugs (except for use of ACEI/ARB drugs strata), use of antidiabetic drugs (except for use of antidiabetic drugs strata), eGFR, FPG and 2 h PG. aData were analysed with further adjustment for duration of diabetes. bData were analysed in individuals with diabetes, including those newly diagnosed and those who have been previously diagnosed. (2 h PG, 2 h postload glucose; ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; FPG, fasting plasma glucose; eGFR, estimated glomerular filtration rate; HbA1c, glycated haemoglobin A1c; HDL-c, high-density lipoprotein cholesterol; LDL-c, low-density lipoprotein cholesterol; SBP, systolic blood pressure; TG, triglyceride).
Mentions: Using participants with HbA1c≤37 mmol/mol (5.5%) as the reference group, a dose–response relationship was found between HbA1c levels and risks of low-grade albuminuria (table 3). Although the magnitude of association was decreased after adjustment for confounding factors, it remained significant, especially for groups with higher HbA1c levels. Further adjustment for FPG and 2 h PG caused little change and the dose–response relationship still remained (ORs were 1.00, 1.05, 1.25, 1.40 and 2.21 for HbA1c categories of ≤37 mmol/mol (5.5%), 38–42 mmol/mol (5.6–6.0%), 43–48 mmol/mol (6.1–6.5%), 49–53 mmol/mol (6.6–7.0%) and >53 mmol/mol (7.0%), respectively; pfor trend <0.0001, table 3). The association between low-grade albuminuria and HbA1c was fairly consistent among subgroups (p values for interaction >0.05), except for the subgroup of obesity (p value for interaction=0.033; figure 2). Moreover, the receiver operating characteristic curve (ROC) analysis revealed that the area under the curve was 0.58 (0.56–0.59) and the optimal cut-off value of HbA1c for low-grade albuminuria was 39 mmol/mol (5.7%) with the largest Youden Index.

Bottom Line: This was a cross-sectional study involving 9188 participants aged 40 years or older.All participants underwent a standard 75 g oral glucose tolerance test.Low-grade albuminuria was defined as the highest quartile of urinary albumin-to-creatinine ratio (ACR) (>6.10 mg/g in males and >8.76 mg/g in females) in respondents without microalbuminuria or macroalbuminuria.

View Article: PubMed Central - PubMed

Affiliation: Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai, China Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.

No MeSH data available.


Related in: MedlinePlus