[Correlation of type 2 diabetes and impaired glucose regulation with chronic kidney disease in middle-aged and elderly individuals].

OBJECTIVE

To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou.

METHODS

Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR.

RESULTS

Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups (P < 0.05). In IGR group, age, hypertension, and hypertriglyceridemia were positively correlated with the risk of RI (OR: 1.113, 1.904, and 2.608, respectively; P < 0.05). In diabetes group, age, coronary heart disease, obesity, hypertriglyceridemia, and elevated LDL-C level were positively correlated with the risk of RI (OR: 1.069, 2.535, 3.359, 1.827, and 2.690, respectively; P < 0.05). Logistic regression analysis showed that diabetes mellitus significantly increased the risk of albuminuria (OR: 1.543, P=0.000) and RI (OR: 1.446, P=0.005). Logistic regression analysis and multivariate regression analysis showed that although the deterioration trends of eGFR were similar in diabetes group and IGR group, IGR was not a significant risk factor for albuminuria or RI (OR:1.057, P=0.355; OR: 0.918, P=0.614).

CONCLUSIONS

Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.