Elevated One-Hour Post-Load Glucose Is Independently Associated with Albuminuria: A Cross-Sectional Population Study

Abstract

The purpose of this study was to examine and compare the associations between albuminuria and fasting (FPG), 1 h post-load (1 h PG) and 2 h post-load plasma glucose (2 h PG) in an oral glucose tolerance test (OGTT). A total of 496 people free of known diabetes (mean age 72 years) participated in the examinations including the OGTT with plasma glucose measurements at 0, 1, and 2 h and levels of HbA1c. Albuminuria was determined by the urinary albumin-to-creatinine ratio and was defined as ≥3.0 mg/mmol. Compared with those without albuminuria, participants with albuminuria had significantly higher 1 h PG and 2 h PG levels, but not FPG or HbA1c levels. An elevated 1 h PG increased the estimated odds ratio of albuminuria more than three times in people with prediabetic 1 h PG (8.6–11.5 mmol/L: OR 3.60; 95% CI 1.70–7.64) and diabetic 1 h PG (≥11.6 mmol/L: OR 3.05; 95% CI 1.29–7.23). After adjusting for blood pressure and age, the association of elevated 1 h PG with albuminuria remained significant. Prediabetic or diabetic FPG, 2 h PG, or HbA1c did not have a statistically significant association with albuminuria. These findings suggest that 1 h PG seems to be the best glycemic parameter and is useful in recognizing persons with an elevated risk of early kidney disease due to hyperglycemia.

Special Issue “Clinical Epidemiology of Diabetes and Its Complications”

“…Therefore, physicians have been asked to more carefully manage blood glucose levels and diagnose and treat complications earlier, in a manner that lowers the risk of coronavirus exposure as much as possible. The first article in this issue, by Saunajoki et al [ 12 ], which is a cross-sectional survey of 496 individuals without a history of either prediabetes or diabetes, demonstrated that plasma glucose levels measured 1 h after a 75 g oral glucose tolerance test were apparently the best glycemic predictor of the presence of albuminuria. This finding may suggest that the blood glucose level 1 h after a 75 g oral glucose tolerance test is predictive of greater risk of kidney disease.…”