Relationship Between Different Glucose Metabolism And Chronic Kidney Disease Among Middle-aged And Elderly Individuals In Lanzhou

Objective: To explore the relationship between different glucose metabolism and chronic kidney disease(CKD)among middle-aged and elderly individuals in Lanzhou.Methods: Based on the baseline data of "REACTION study" in Lanzhou area,10038 residents aged 40~75 years in Lanzhou community were selected as the study objects,and they were divided into normal glucose tolerance(NGT)group,impaired glucose regulation(IGR)group and type 2 diabetes mellitus(DM)group.Estimated glomerular filtration rate(eGFR)and urinary albumin/creatinine Ratio(ACR)were used to evaluate renal function.Covariance analysis was used to compare the prevalence of albuminuria and the level of eGFR.Logistic regression analysis was used to investigate whether IGR or T2 DM were risk factors for albuminuria and RI.The trend of eGFR increasing with ACR was studied by multiple regression analysis.Results:(1)Among all individuals,the prevalence of albuminuria,CKD and RI were 26.2%,27.4% and 2.5% respectively.The prevalence of albuminuria,CKD and RI in T2 DM group were 35.4%,37.2% and 4.5% respectively,which were significantly higher than that in IGR group(25.8%,27.0% and 2.5%)and NGT group(21.5%,22.5% and 1.8%)(P<0.05).(2)The prevalence of albuminuria,CKD and RI in individuals with hypertension was significantly higher than those with normal blood pressure(all P < 0.05).(3)With the progress of CKD1 to CKD4,the proportion of elderly individuals,history of DM,history of hypertension,history of dyslipidemia,history of coronary heart disease,T2 DM,hypertension and dyslipidemia increased significantly(P<0.05).(4)In the IGR individuals,age,hypertension,and hypertriglyceridemia were positively correlated with the risk of RI(OR: 1.113,1.904,2.608,P<0.05).In the T2 DM individuals,age,coronary heart disease,obesity,hypertriglyceridemia,and hyper LDL-Cemia were positively correlated with the risk of RI(OR: 1.069,2.535,3.359,1.827,2.690,all P<0.05).(4)Age,hypertension and hypertriglyceridemia were positively correlated with the risk of RI(OR: 1.113,1.904,2.608,all P<0.05).In T2 DM individuals,age,coronary heart disease,obesity,hypertriglyceridemia and hyper LDL-Cemia were positively correlated with the risk of RI(OR: 1.069,2.535,3.359,1.827,2.690,all P < 0.05).(5)Logistic regression analysis showed that T2 DM significantly increased the risk of albuminuria and RI,OR was 1.543(P=0.000)and 1.446(P=0.005),respectively.(6)Logistic regression analysis and multiple regression analysis showed that although the deterioration trend of eGFR in T2 DM and IGR individuals was similar,IGR is not a significant risk factor for albuminuria or RI(OR=1.057,P=0.355;OR=0.918,P=0.614).Conclusion: T2 DM is a significant risk factor for albuminuria and RI,but IGR is not a significant risk factor for albuminuria and RI.