Glomerular filtration rate estimated by differing measures and risk of all-cause mortality among Chinese individuals without or with diabetes: A nationwide prospective study

Liu，Yu Jie1; Li，Fu Rong2; Chen，Cai Long3; Wan，Zhong Xiao1; Chen，Jin Si1; Yang，Jing1,4; Liu，Rong5; Xu，Jia Ying6; Zheng，Yan7,8,9; Qin，Li Qiang1,5; Chen，Guo Chong1

2023

10.1111/1753-0407.13393

Journal of Diabetes   影响因子和分区

1753-0393

1753-0407

Background: Whether estimated glomerular filtration rates (eGFRs) by differing biomarkers are differentially associated with mortality or whether the associations differ by diabetes status remains unclear, especially in Chinese population. Methods: We included 6995 participants without diabetes (mean age: 60.4 years) and 1543 with diabetes (mean age: 61.8 years). Each eGFR measure was divided into normal (≥90 mL/min/1.73 m), modestly declined (60 to <90 mL/min/1.73 m), and chronic kidney disease (CKD) (<60 mL/min/1.73 m) groups. Cox proportional hazards models were used to estimate hazard ratio (HR) of all-cause mortality associated with each eGFR. Results: Over a follow-up of 7 years, 677 and 215 deaths occurred among individuals without or with diabetes, respectively. Among those without diabetes, all measures of modestly declined eGFR were not associated with mortality, whereas CKD defined by eGFR cystatin C (eGFRcys) and eGFR creatinine (eGFRcr)-cys (HRs were 1.71 and 1.55, respectively) but not by eGFRcr were associated with higher risk of mortality. Among diabetes, all measures of modestly declined eGFR (HRs: 1.53, 1.56, and 2.09 for eGFRcr, eGFRcys, and eGFRcr-cys, respectively) and CKD (HRs: 2.57, 2.99, and 3.92 for eGFRcr, eGFRcys, and eGFRcr-cys, respectively) were associated with higher risk of mortality. Regardless of diabetes status, an addition of eGFRcys or eGFRcr-cys to traditional risk factors lead to a larger improvement in the prediction of all-cause mortality risk than adding eGFRcr. Conclusions: The association of eGFR with mortality risk appeared to be varied by its measures and by diabetes status among middle-aged and older Chinese, which needs to be considered in clinical practice.

all-cause mortality chronic kidney disease creatinine cystatin C diabetes estimated glomerular filtration rate

SCI

英语

其他

Suzhou science and technology development plan (Livelihood Technology)[SS202009] ; Chinese Postdoctoral Science Foundation[2022M721463]

Endocrinology & Metabolism

Endocrinology & Metabolism

WOS:000979732700001

WILEY

2-s2.0-85158073058

Scopus

1.Department of Nutrition and Food Hygiene,School of Public Health,Suzhou Medical College of Soochow University,Suzhou,China
2.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,China
3.Children Health Management Center,Children's Hospital of Soochow University,Suzhou,China
4.Department of Clinical Nutrition,The First Affiliated Hospital of Soochow University,Suzhou,China
5.Department of Endocrine,Changzhou Geriatric Hospital Affiliated to Soochow University,Changzhou,China
6.State Key Laboratory of Radiation Medicine and Protection,School of Radiation Medicine and Protection,Suzhou Medical College of Soochow University,Suzhou,China
7.State Key Laboratory of Genetic Engineering,Human Phenome Institute,and School of Life Sciences,Fudan University,Shanghai,China
8.Ministry of Education Key Laboratory of Public Health Safety,School of Public Health,Fudan University,Shanghai,China
9.National Clinical Research Center for Aging and Medicine,Huashan Hospital,Fudan University,Shanghai,China

Liu，Yu Jie,Li，Fu Rong,Chen，Cai Long,et al. Glomerular filtration rate estimated by differing measures and risk of all-cause mortality among Chinese individuals without or with diabetes: A nationwide prospective study[J]. Journal of Diabetes,2023,15(6).

Liu，Yu Jie.,Li，Fu Rong.,Chen，Cai Long.,Wan，Zhong Xiao.,Chen，Jin Si.,...&Chen，Guo Chong.(2023).Glomerular filtration rate estimated by differing measures and risk of all-cause mortality among Chinese individuals without or with diabetes: A nationwide prospective study.Journal of Diabetes,15(6).

Liu，Yu Jie,et al."Glomerular filtration rate estimated by differing measures and risk of all-cause mortality among Chinese individuals without or with diabetes: A nationwide prospective study".Journal of Diabetes 15.6(2023).