Abstract
Objective
Whether early stages of kidney dysfunction assessed by the estimated glomerular filtration
rate from cystatin C measurements (eGFRCysC) rather than from creatinine measurements
(eGFRCr) would more precisely reflect the risk of developing type 2 diabetes (T2D)
has not been clarified. We compared the risk of developing T2D associated with renal
dysfunction indicated by eGFRCysC or eGFRCr measurements.
Methods
Studied were 2131 Japanese individuals without diabetes. Hazard ratios (HRs) for the
development of T2D over 3–5 y were calculated across categories of eGFRCysC and eGFRCr,
respectively.
Results
Reduced levels of eGFRCysC were associated with a step-wise increase in the cumulative
incidence rate of T2D (p = 0.007). In comparison with the eGFRCysC >85th percentile group (≥117.4 ml/min/1.73 m2), the lowest group, which was the eGFRCysC <15th percentile group (<86.2 ml/min/1.73 m2), had an adjusted HR of 2.30 (95% CI 1.13, 4.68) for T2D. Compared with the eGFRCr
>85th percentile group, the lowest eGFRCr group (<15th percentile) had an HR of 1.19
(0.63, 2.24) for T2D. However, individuals with eGFRCr <60 ml/min/1.73 m2 had a significantly increased risk of T2D. Clustering of both low eGFRCysC and low
eGFRCr further elevated the HR for T2D compared with the presence of either.
Conclusions
Although eGFRCr in ranges indicating chronic kidney disease reflected an elevated
risk of developing diabetes, earlier stages of kidney dysfunction indicated by reduced
eGFRCysC, which could not be captured by reduced eGFRCr, would be a marker for an
elevated risk of developing T2D.
Keywords
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Article info
Publication history
Published online: February 01, 2016
Accepted:
January 22,
2016
Received in revised form:
January 17,
2016
Received:
July 16,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
