TY - JOUR
T1 - Serum Levels of 1,5-Anhydroglucitol and Risk of Incident End-Stage Renal Disease
AU - Rebholz, Casey M.
AU - Grams, Morgan E.
AU - Chen, Yuan
AU - Gross, Alden L.
AU - Sang, Yingying
AU - Coresh, Josef
AU - Selvin, Elizabeth
N1 - Publisher Copyright:
© 2017 The Author(s). Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.
PY - 2017/10/15
Y1 - 2017/10/15
N2 - 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.
AB - 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.
KW - 1,5-Anhydroglucitol
KW - Biomarkers
KW - Diabetes mellitus
KW - End-stage renal disease
KW - Epidemiology
KW - Glomerular filtration rate
KW - Hyperglycemia
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U2 - 10.1093/aje/kwx167
DO - 10.1093/aje/kwx167
M3 - Article
C2 - 28535187
AN - SCOPUS:85031945348
SN - 0002-9262
VL - 186
SP - 952
EP - 960
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 8
ER -