PDF(Pubmed)
Abstract：
OBJECTIVE: The present body of evidence regarding the correlation between the estimated glomerular filtration rate (eGFR) and the reversal of impaired fasting glucose (IFG) to normoglycemia remains constrained. Consequently, the objective of our study is to examine the relationship between eGFR and the restoration of normoglycemia in individuals with IFG.
METHODS: This retrospective cohort study consecutively collected data from 24,541 non-selective participants with IFG at Rich Healthcare Group in China from January 2010 to 2016. We aimed to investigate the association between baseline eGFR and reversion to normoglycemia using the Cox proportional-hazards regression model. Through the utilization of a Cox proportional hazards regression model featuring cubical spline smoothing, we were able to ascertain the non-linear correlation between eGFR and the return to normoglycemia. Furthermore, various sensitivity and subgroup analyses were carried out, and a competing risk multivariate Cox regression was employed to examine the progression to diabetes as a competing risk for the reversal of normoglycemic events.
RESULTS: In our study, comprising 24,541 participants, the average age was 49.25 ± 13.77 years, with 66.28% being male. The baseline eGFR mean was 104.16 ± 15.78 ml/min per 1.73 m2. During a median follow-up period of 2.89 years, we observed a reversion rate to normoglycemia of 45.50%. Upon controlling for covariates, our findings indicated a positive correlation between eGFR and the probability of returning to normoglycemia (HR = 1.008, 95% CI 1.006-1.009). In addition, a non-linear association was observed between eGFR and the likelihood of transitioning from IFG to normoglycemia. The inflection point of eGFR was found to be 111.962 ml/min per 1.73 m2, with HRs of 1.003 (95% CI 1.001, 1.005) on the left side of the point and 1.019 (95% CI 1.015, 1.022) on the right side. Our robust results were supported by competing risks multivariate Cox\'s regression and sensitivity analysis.
CONCLUSIONS: The findings of our investigation indicate a favorable and non-linear correlation between eGFR and the restoration of normoglycemia in Chinese individuals with IFG. Specifically, a reduction in renal function at an early stage in these patients may considerably diminish the likelihood of attaining normoglycemia.
METHODS: This retrospective cohort study consecutively collected data from 24,541 non-selective participants with IFG at Rich Healthcare Group in China from January 2010 to 2016. We aimed to investigate the association between baseline eGFR and reversion to normoglycemia using the Cox proportional-hazards regression model. Through the utilization of a Cox proportional hazards regression model featuring cubical spline smoothing, we were able to ascertain the non-linear correlation between eGFR and the return to normoglycemia. Furthermore, various sensitivity and subgroup analyses were carried out, and a competing risk multivariate Cox regression was employed to examine the progression to diabetes as a competing risk for the reversal of normoglycemic events.
RESULTS: In our study, comprising 24,541 participants, the average age was 49.25 ± 13.77 years, with 66.28% being male. The baseline eGFR mean was 104.16 ± 15.78 ml/min per 1.73 m2. During a median follow-up period of 2.89 years, we observed a reversion rate to normoglycemia of 45.50%. Upon controlling for covariates, our findings indicated a positive correlation between eGFR and the probability of returning to normoglycemia (HR = 1.008, 95% CI 1.006-1.009). In addition, a non-linear association was observed between eGFR and the likelihood of transitioning from IFG to normoglycemia. The inflection point of eGFR was found to be 111.962 ml/min per 1.73 m2, with HRs of 1.003 (95% CI 1.001, 1.005) on the left side of the point and 1.019 (95% CI 1.015, 1.022) on the right side. Our robust results were supported by competing risks multivariate Cox\'s regression and sensitivity analysis.
CONCLUSIONS: The findings of our investigation indicate a favorable and non-linear correlation between eGFR and the restoration of normoglycemia in Chinese individuals with IFG. Specifically, a reduction in renal function at an early stage in these patients may considerably diminish the likelihood of attaining normoglycemia.
摘要：
目的：关于估计的肾小球滤过率（eGFR）与空腹血糖受损（IFG）逆转为正常血糖之间的相关性的现有证据仍然有限。因此,我们的研究目的是研究eGFR与IFG患者血糖恢复正常之间的关系.
方法：这项回顾性队列研究连续收集了2010年1月至2016年中国RichHealthcareGroup的24,541名非选择性IFG参与者的数据。我们旨在使用Cox比例风险回归模型研究基线eGFR与血糖恢复正常之间的关联。通过利用以三次样条平滑为特征的Cox比例风险回归模型，我们能够确定eGFR与血糖恢复正常之间的非线性相关性.此外，进行了各种敏感性和亚组分析，采用竞争风险多变量Cox回归检验糖尿病进展作为正常血糖事件逆转的竞争风险.
结果：在我们的研究中，由24,541名参与者组成，平均年龄为49.25±13.77岁，66.28%是男性。基线eGFR平均值为104.16±15.78ml/min/1.73m2。在2.89年的中位随访期内，我们观察到血糖恢复正常率为45.50%。在控制协变量时，我们的研究结果表明,eGFR与血糖恢复正常的概率呈正相关(HR=1.008,95%CI1.006~1.009).此外,eGFR与从IFG转变为血糖正常的可能性之间存在非线性关联.发现eGFR的拐点为每1.73m2111.962ml/min，点左侧的HR为1.003（95％CI1.001，1.005），右侧为1.019（95％CI1.015，1.022）。我们的稳健结果得到了竞争风险多变量Cox回归和敏感性分析的支持。
结论：我们的研究结果表明，在中国IFG患者中，eGFR与血糖恢复正常之间存在良好的非线性相关性。具体来说,这些患者早期肾功能下降可能会大大降低血糖正常的可能性.
方法：这项回顾性队列研究连续收集了2010年1月至2016年中国RichHealthcareGroup的24,541名非选择性IFG参与者的数据。我们旨在使用Cox比例风险回归模型研究基线eGFR与血糖恢复正常之间的关联。通过利用以三次样条平滑为特征的Cox比例风险回归模型，我们能够确定eGFR与血糖恢复正常之间的非线性相关性.此外，进行了各种敏感性和亚组分析，采用竞争风险多变量Cox回归检验糖尿病进展作为正常血糖事件逆转的竞争风险.
结果：在我们的研究中，由24,541名参与者组成，平均年龄为49.25±13.77岁，66.28%是男性。基线eGFR平均值为104.16±15.78ml/min/1.73m2。在2.89年的中位随访期内，我们观察到血糖恢复正常率为45.50%。在控制协变量时，我们的研究结果表明,eGFR与血糖恢复正常的概率呈正相关(HR=1.008,95%CI1.006~1.009).此外,eGFR与从IFG转变为血糖正常的可能性之间存在非线性关联.发现eGFR的拐点为每1.73m2111.962ml/min，点左侧的HR为1.003（95％CI1.001，1.005），右侧为1.019（95％CI1.015，1.022）。我们的稳健结果得到了竞争风险多变量Cox回归和敏感性分析的支持。
结论：我们的研究结果表明，在中国IFG患者中，eGFR与血糖恢复正常之间存在良好的非线性相关性。具体来说,这些患者早期肾功能下降可能会大大降低血糖正常的可能性.
