Relationship of diabetes with renal dysfunction in hypertensive adults
We aimed to examine the relationship of diabetes with the estimated glomerular filtration rate (eGFR)-based renal function in the Chinese hypertensive adults.
This cross-sectional analysis included a total of 18,641 hypertensive adults aged 45 to 75 years. The relationship of diabetes (a fasting glucose ≥7.0 mmol/L or self-reported use of hypoglycemic agents or physician diagnosed diabetes) with glomerular hyperfiltration (an absolute eGFR >90th percentile after adjusting for sex, age), hypofiltration (an eGFR <10th percentile and ≥60 mL/min/1.73 m2), and reduced eGFR (an eGFR <60 mL/min/1.73 m2) were estimated by multiple logistic regressions.
Both the cut-points for hyperfiltration and hypofiltration decreased with age increased, ranging from 115 to 91 mL/min/1.73 m2 and 91 to 67 mL/min/1.73 m2, respectively. In the multiple logistic models, diabetes was positively associated with glomerular hyperfiltration (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.93–2.47), hypofiltration (1.24, 1.05–1.46), and reduced eGFR (2.88, 2.21–3.76). Furthermore, the stronger association between diabetes and hyperfiltration was found in those with younger age (P for interaction <.001), or higher total cholesterol (TC) levels (P for interaction = .008). Consistently, significant association between diabetes and hypofiltration was only observed in participants with younger age (P for interaction = .043). And detrimentally interaction between diabetes and higher TC levels was also found (P for interaction <.001) on the risk of reduced eGFR.
Diabetes was significantly associated with the impairment of renal function, particularly in those with younger age or with higher TC levels. Fasting glucose should be monitored as a marker to identify those with early renal dysfunction.