Clinical interventions in aging · 2026
Association Between Estimated Glucose Disposal Rate and Chronic Kidney Disease in Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Zhejiang, China.
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Chen Xiangyu, Hu Ruying, Lu Feng, Zhong Jieming
Аннотация
PURPOSE: To examine the association between estimated glucose disposal rate (eGDR) and study-defined chronic kidney disease (CKD) among elderly patients with type 2 diabetes mellitus (T2DM) in Zhejiang Province, China.
METHODS: This cross-sectional study included 713 elderly T2DM patients (≥60 years) from Zhejiang Province, conducted between March and November 2018 as part of the China National Diabetic Chronic Complications Study. Study-defined CKD was operationally defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g. Multivariable logistic regression was used to assess the association of eGDR with study-defined CKD. Restricted cubic spline (RCS) analysis examined the shape of the association. Generalized additive models evaluated associations with UACR and eGFR, and receiver operating characteristic (ROC) analysis assessed discrimination.
RESULTS: Among 713 participants, 245 (34.36%) met the study-defined CKD criteria. Each 1-unit increase in eGDR was associated with lower odds of study-defined CKD after multivariable adjustment (OR = 0.78, 95% CI: 0.70-0.86; p < 0.001). Compared with the lowest eGDR tertile, the adjusted ORs (95% CIs) were 0.51 (0.35-0.76) for the middle tertile and 0.31 (0.20-0.48) for the highest tertile (both p < 0.001). RCS analysis demonstrated an approximately linear inverse association between eGDR and study-defined CKD (p for nonlinearity > 0.05). eGDR was inversely associated with UACR (ρ = -0.277, p < 0.001) whereas the association between eGDR and eGFR was not statistically significant. The discriminative ability of eGDR for study-defined CKD was modest (AUC = 0.65, 95% CI: 0.61-0.70). The direction of the association was generally consistent across subgroups, with no significant interactions.
CONCLUSIONS: Lower eGDR was associated with a higher prevalence of study-defined CKD in elderly patients with T2DM, with an approximately linear cross-sectional association. Prospective studies are needed to establish temporality and assess whether eGDR adds information beyond established CKD assessment.
METHODS: This cross-sectional study included 713 elderly T2DM patients (≥60 years) from Zhejiang Province, conducted between March and November 2018 as part of the China National Diabetic Chronic Complications Study. Study-defined CKD was operationally defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g. Multivariable logistic regression was used to assess the association of eGDR with study-defined CKD. Restricted cubic spline (RCS) analysis examined the shape of the association. Generalized additive models evaluated associations with UACR and eGFR, and receiver operating characteristic (ROC) analysis assessed discrimination.
RESULTS: Among 713 participants, 245 (34.36%) met the study-defined CKD criteria. Each 1-unit increase in eGDR was associated with lower odds of study-defined CKD after multivariable adjustment (OR = 0.78, 95% CI: 0.70-0.86; p < 0.001). Compared with the lowest eGDR tertile, the adjusted ORs (95% CIs) were 0.51 (0.35-0.76) for the middle tertile and 0.31 (0.20-0.48) for the highest tertile (both p < 0.001). RCS analysis demonstrated an approximately linear inverse association between eGDR and study-defined CKD (p for nonlinearity > 0.05). eGDR was inversely associated with UACR (ρ = -0.277, p < 0.001) whereas the association between eGDR and eGFR was not statistically significant. The discriminative ability of eGDR for study-defined CKD was modest (AUC = 0.65, 95% CI: 0.61-0.70). The direction of the association was generally consistent across subgroups, with no significant interactions.
CONCLUSIONS: Lower eGDR was associated with a higher prevalence of study-defined CKD in elderly patients with T2DM, with an approximately linear cross-sectional association. Prospective studies are needed to establish temporality and assess whether eGDR adds information beyond established CKD assessment.