HbA 1C variability increases the risk of decline in glomerular filtration rate in elderly patients with type 2 diabetes
10.3760/cma.j.cn311282-20220218-00087
- VernacularTitle:高HbA 1C变异性增加老年2型糖尿病患者肾小球滤过率下降风险
- Author:
Huan LIU
1
;
Yao FAN
;
Yuxia WU
;
Haidi WU
;
Guoqing LI
;
Yan HU
;
Jing DAI
;
Yun YU
;
Yongzhen MO
;
Wei TANG
Author Information
1. 苏州大学医学部护理学院 215006
- Keywords:
Elderly;
Diabetes mellitus, type 2;
HbA 1C variability;
Glomerular filtration rate
- From:
Chinese Journal of Endocrinology and Metabolism
2022;38(10):859-864
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the association of HbA 1C level and variability with annual decline in glomerular filtration rate in elderly patients with type 2 diabetes. Methods:A total of 527 elderly type 2 diabetic patients with baseline estimated glomerular filtration rate(eGFR)≥60 mL·min -1·(1.73 m 2) -1 at the diabetes center of a tertiary hospital in Jiangsu province were included and followed up. The mean value and the variability of HbA 1C, including standard deviation(HbA 1C-SD), variation coefficient(HbA 1C-CV), and adjusted standard deviation(Adj-HbA 1C-SD) were calculated. According to the annual decreased rate of eGFR, the patients were divided into △eGFR>5% group and △eGFR≤5% group. Cox proportional risk regression model was used to evaluate the relationship between HbA 1C variability and the risk of decreased glomerular filtration rate. Results:With a mean follow-up time of 19 months, there were 176 patients whose △eGFR>5%. Compared with △eGFR≤5% group, the HbA 1C-mean and HbA 1C variability were significantly higher in △eGFR>5% group( P<0.05). Cox regression analysis showed that HbA 1C-mean, HbA 1C-SD, HbA 1C-CV, and Adj-HbA 1C-SD were significantly correlated with decreased glomerular filtration rate. After adjustment for age, gender, HbA 1C-mean, and other factors, only Adj-HbA 1C-SD was correlated with renal insufficiency [ HR=3.32(1.68-6.57)]. Conclusions:HbA 1C variability is independently associated with annual decline in glomerular filtration rate in elderly patients with type 2 diabetes. The Adj-HbA 1C-SD is the most sensitive indicator in predicting decreased glomerular filtration rate.
