Serum Levels of 1, 5-Anhydroglucitol and Risk of Incident End-Stage Renal Disease. Issue 8 (23rd May 2017)

• Record Type: Journal Article
• Authors: Rebholz, Casey M; Grams, Morgan E; Chen, Yuan; Gross, Alden L; Sang, Yingying; Coresh, Josef; Selvin, Elizabeth
• Is Part Of: American journal of epidemiology. Volume 186:Issue 8(2017)
• Page Start: 952
• Page End: 960
• Publication Date: 2017-05-23
• Subjects: 1, 5-anhydroglucitol -- biomarkers -- diabetes mellitus -- end-stage renal disease -- epidemiology -- glomerular filtration rate -- hyperglycemia; Epidemiology -- Periodicals; Public health -- Periodicals; 614.4
• DOI: 10.1093/aje/kwx167
• Languages: English
• ISSNs: 0002-9262

Abstract

Abstract: Glycemic excursions, independent of average glucose, have been implicated in the development of diabetic complications. It is unknown whether low levels of 1, 5-anhydroglucitol (1, 5-AG) are associated with advanced stages of kidney disease independent of kidney function and glycemia. In the Atherosclerosis Risk in Communities Study ( n = 13, 277 from 4 US communities), we used structural equation modeling to estimate the association between serum 1, 5-AG levels and end-stage renal disease (ESRD) from baseline (1990–1992) through 2013 with adjustment for demographics, risk factors, a latent variable for glycemia (diabetes status, fasting glucose, glycated hemoglobin (HbA1c ), fructosamine, glycated albumin), and a latent variable for kidney function (creatinine, cystatin C, β2 -microglobulin). After adjusting for demographics, risk factors, and the latent variable for kidney function, the linear spline terms representing 1, 5-AG levels <6.0 μg/mL (incidence rate ratio (IRR) = 0.79, 95% confidence interval (CI): 0.70, 0.88) and 6.0–9.9 μg/mL (IRR = 0.80, 95% CI: 0.70, 0.92) were significantly associated with ESRD. After additionally adjusting for the latent variable for glycemia, low 1, 5-AG levels (<6.0 μg/mL) were no longer significantly associated with ESRD (IRR = 0.92, 95% CI: 0.81, 1.05). In conclusion, low 1, 5-AG levels are associated with higher risk of incident ESRD independent of baseline kidney function but not independent of glycemia.