One-hour postload plasma glucose levels are associated with kidney dysfunction

Clin J Am Soc Nephrol. 2010 Nov;5(11):1922-7. doi: 10.2215/CJN.03240410. Epub 2010 Jul 1.

Abstract

Background and objectives: A cutoff of 155 mg/dl for 1-hour postload plasma glucose (1hPG) during the oral glucose tolerance test (OGTT) is able to identify patients who are at high risk for type 2 diabetes and vascular atherosclerosis. We aimed to examine whether individuals with 1hPG ≥155 mg/dl are also at increased risk for chronic kidney disease (CKD).

Design, setting, participants, & measurements: Atherosclerosis risk factors, OGTT, and estimated GFR by Chronic Kidney Disease Epidemiology Collaboration equation were analyzed in 1075 white individuals without diabetes.

Results: The area under the receiver operating characteristic curve for 1hPG was the highest (0.700) compared with the areas under the receiver operating characteristic curve of 0, 30-minute, and 2-hour glucose concentrations. Individuals with 1hPG ≥155 mg/dl had a worse cardiometabolic risk profile, exhibiting significantly higher body mass index, BP, triglycerides, and fasting insulin levels and lower HDL, IGF-1 levels, and insulin sensitivity, than individuals with 1hPG <155 mg/dl. Estimated GFR was significantly lower in individuals with 1hPG ≥155 mg/dl. In a logistic regression model adjusted for age and gender, individuals with 1hPG ≥155 mg/dl showed an increased risk for CKD compared with individuals with 1hPG <155 mg/dl. When the logistic regression analysis was restricted to individuals who had normal glucose tolerance, those with 1hPG ≥155 mg/dl showed a higher risk for CKD compared with individuals with 1hPG <155 mg/dl.

Conclusions: These data suggest that a cutoff point of 155 mg/dl for the 1hPG during OGTT may be helpful in the identification of individuals who are at increased risk for CKD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Chi-Square Distribution
  • Chronic Disease
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate*
  • Glucose Tolerance Test
  • Humans
  • Italien
  • Kidney / physiopathology*
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / etiology
  • Kidney Diseases / physiopathology
  • Logistic Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • ROC Curve
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Blood Glucose