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논문 기본 정보

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학술저널
저자정보
Hua-Xing Huang (First Affiliated Hospital of Soochow University) Liang-Lan Shen (Nantong University) Hai-Yan Huang (Nantong University) Li-Hua Zhao (Nantong University) Feng Xu (Nantong University) Dong-Mei Zhang (Nantong University) Xiu-Lin Zhang (Nantong University) Tong Chen (Nantong University) Xue-Qin Wang (Nantong University) Yan Xie (First Affiliated Hospital of Soochow University) Jian-Bin Su (Nantong University)
저널정보
대한당뇨병학회 Diabetes and Metabolism Journal Diabetes and Metabolism Journal Vol.45 No.6
발행연도
2021.11
수록면
868 - 879 (12page)
DOI
10.4093/dmj.2020.0149

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Background: Type 2 diabetes mellitus (T2DM) is characterized by elevated fasting glucagon and impaired suppression of postprandial glucagon secretion, which may participate in diabetic complications. Therefore, we investigated the associations of plasma glucagon with estimated glomerular filtration rate (eGFR), albuminuria and diabetic kidney disease (DKD) in T2DM patients.Methods: Fasting glucagon and postchallenge glucagon (assessed by area under the glucagon curve [AUCgla]) levels were determined during oral glucose tolerance tests. Patients with an eGFR <60 mL/min/1.73 m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g who presented with diabetic retinopathy were identified as having DKD.Results: Of the 2,436 recruited patients, fasting glucagon was correlated with eGFR and UACR (r=?0.112 and r=0.157, respectively; P<0.001), and AUCgla was also correlated with eGFR and UACR (r=?0.267 and r=0.234, respectively; P<0.001). Moreover, 31.7% (n=771) presented with DKD; the prevalence of DKD was 27.3%, 27.6%, 32.5%, and 39.2% in the first (Q1), second (Q2), third (Q3), and fourth quartile (Q4) of fasting glucagon, respectively; and the corresponding prevalence for AUCgla was 25.9%, 22.7%, 33.7%, and 44.4%, respectively. Furthermore, after adjusting for other clinical covariates, the adjusted odds ratios (ORs; 95% confidence intervals) for DKD in Q2, Q3, and Q4 versus Q1 of fasting glucagon were 0.946 (0.697 to 1.284), 1.209 (0.895 to 1.634), and 1.521 (1.129 to 2.049), respectively; the corresponding ORs of AUCgla were 0.825 (0.611 to 1.114), 1.323 (0.989 to 1.769), and 2.066 (1.546 to 2.760), respectively. Additionally, when we restricted our analysis in patients with glycosylated hemoglobin <7.0% (n=471), we found fasting glucagon and AUCgla were still independently associated with DKD.Conclusion: Both increased fasting and postchallenge glucagon levels were independently associated with DKD in T2DM patients.
#Diabetes mellitus #type 2 #Diabetic nephropathies #Glucagon

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참고문헌 (47)

참고문헌 신청
Afkarian M / 2016 / Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014 / JAMA 316:602~610 google schola Koye DN / 2018 / The global epidemiology of diabetes and kidney disease / Adv Chronic Kidney Dis 25:121~132 google schola Harding JL / 2019 / Global trends in diabetes complications : a review of current evidence / Diabetologia 62:3~16 google schola Fox CS / 2012 / Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes : a meta-analysis / Lancet 380:1662~1673 google schola Mohammedi K / 2017 / Comparative effects of microvascular and macrovascular disease on the risk of major outcomes in patients with type 2 diabetes / Cardiovasc Diabetol 16:95 google schola

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