The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients
ObjectiveThis study aimed to explore the relationship between short-term (≤12 months) changes in the estimated glomerular filtration rate (eGFR) and hemoglobin A1c (HbA1c) in patients with type 2 diabetes (T2D).MethodA total of 2,599 patients with T2D were enrolled if they were registered in the Dia...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.723720/full |
| _version_ | 1798021517633650688 |
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| author | Lingwang An Qiuzhi Yu Linhui Chen Hong Tang Yanjun Liu Qun Yuan Yu Ji Yaujiunn Lee Juming Lu Juming Lu |
| author_facet | Lingwang An Qiuzhi Yu Linhui Chen Hong Tang Yanjun Liu Qun Yuan Yu Ji Yaujiunn Lee Juming Lu Juming Lu |
| author_sort | Lingwang An |
| collection | DOAJ |
| description | ObjectiveThis study aimed to explore the relationship between short-term (≤12 months) changes in the estimated glomerular filtration rate (eGFR) and hemoglobin A1c (HbA1c) in patients with type 2 diabetes (T2D).MethodA total of 2,599 patients with T2D were enrolled if they were registered in the Diabetes Sharecare Information System, were aged 18–75 years, and had 2–3 HbA1c and eGFR measurements within the preceding 12 months. The studied patients were categorized into five groups based on eGFR, i.e., the relatively stable (RS), fast decline (FD), modest decline (MD), modest increase (MI), and fast increase (FI) groups.ResultsThe median eGFR changes from baseline were −22.14, −6.44, 0.00, 6.32, and 20.00 ml/min per 1.73 m2 for patients in the FD, MD, RS, MI, and FI groups, respectively. Up to 1,153 (44.4%) subjects experienced an eGFR decline of ≥3.5 ml/min per 1.73 m2, including 821 (31.6%) FD subjects and 332 (12.8%) MD subjects. A decreased trend was found between the eGFR change and HbA1c decrease category, even after multivariable adjustment. In general, an eGFR FD was frequently found in patients who had an HbA1c reduction of ≥3.00% and a baseline HbA1c ≥8.0%; alternatively, such a result was also observed for a urinary albumin-to-creatinine ratio (UACR) of 30.0–300.0 mg/g, regardless of a diabetes duration of <10.0 or ≥10.0 years, or in patients who had an HbA1c reduction of ≥1.00% accompanied by hyperfiltration.ConclusionsSome patients with T2D experienced an eGFR FD or MD during the ≤12-month follow-up period. A significant downward trend in eGFR change was demonstrated alongside an HbA1c reduction, independent of UACR stage, diabetes duration, and hyperfiltration. Sustained monitoring and cautious interpretation of the HbA1c and eGFR changes will be needed in clinical practice. |
| first_indexed | 2024-04-11T17:14:54Z |
| format | Article |
| id | doaj.art-89253ed938864ea6b538dcf8c16368ab |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-11T17:14:54Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-89253ed938864ea6b538dcf8c16368ab2022-12-22T04:12:42ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-01-011210.3389/fendo.2021.723720723720The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic PatientsLingwang An0Qiuzhi Yu1Linhui Chen2Hong Tang3Yanjun Liu4Qun Yuan5Yu Ji6Yaujiunn Lee7Juming Lu8Juming Lu9Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, ChinaDepartment of Endocrinology, Heilongjiang Ruijing Diabetes Hospital, Haerbin, ChinaDepartment of Endocrinology, Taiyuan Diabetes Hospital, Taiyuan, ChinaDepartment of Share-care Center, Chengdu Ruien Diabetes Hospital, Chengdu, ChinaDepartment of Endocrinology, Lanzhou Ruijing Diabetes Hospital, Lanzhou, ChinaDepartment of Endocrinology, Heilongjiang Ruijing Diabetes Hospital, Haerbin, ChinaDepartment of Endocrinology, Beijing Aerospace General Hospital, Beijing, ChinaLee’s Endocrinology Clinic, Taiwan, ChinaDepartment of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, ChinaDepartment of Endocrinology, The General Hospital of the People’s Liberation Army, Beijing, ChinaObjectiveThis study aimed to explore the relationship between short-term (≤12 months) changes in the estimated glomerular filtration rate (eGFR) and hemoglobin A1c (HbA1c) in patients with type 2 diabetes (T2D).MethodA total of 2,599 patients with T2D were enrolled if they were registered in the Diabetes Sharecare Information System, were aged 18–75 years, and had 2–3 HbA1c and eGFR measurements within the preceding 12 months. The studied patients were categorized into five groups based on eGFR, i.e., the relatively stable (RS), fast decline (FD), modest decline (MD), modest increase (MI), and fast increase (FI) groups.ResultsThe median eGFR changes from baseline were −22.14, −6.44, 0.00, 6.32, and 20.00 ml/min per 1.73 m2 for patients in the FD, MD, RS, MI, and FI groups, respectively. Up to 1,153 (44.4%) subjects experienced an eGFR decline of ≥3.5 ml/min per 1.73 m2, including 821 (31.6%) FD subjects and 332 (12.8%) MD subjects. A decreased trend was found between the eGFR change and HbA1c decrease category, even after multivariable adjustment. In general, an eGFR FD was frequently found in patients who had an HbA1c reduction of ≥3.00% and a baseline HbA1c ≥8.0%; alternatively, such a result was also observed for a urinary albumin-to-creatinine ratio (UACR) of 30.0–300.0 mg/g, regardless of a diabetes duration of <10.0 or ≥10.0 years, or in patients who had an HbA1c reduction of ≥1.00% accompanied by hyperfiltration.ConclusionsSome patients with T2D experienced an eGFR FD or MD during the ≤12-month follow-up period. A significant downward trend in eGFR change was demonstrated alongside an HbA1c reduction, independent of UACR stage, diabetes duration, and hyperfiltration. Sustained monitoring and cautious interpretation of the HbA1c and eGFR changes will be needed in clinical practice.https://www.frontiersin.org/articles/10.3389/fendo.2021.723720/fulldiabetestype 2hemoglobin A1c (HbA1c)estimated glomerular filtration rate (eGFR)hyperfiltration |
| spellingShingle | Lingwang An Qiuzhi Yu Linhui Chen Hong Tang Yanjun Liu Qun Yuan Yu Ji Yaujiunn Lee Juming Lu Juming Lu The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients Frontiers in Endocrinology diabetes type 2 hemoglobin A1c (HbA1c) estimated glomerular filtration rate (eGFR) hyperfiltration |
| title | The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients |
| title_full | The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients |
| title_fullStr | The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients |
| title_full_unstemmed | The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients |
| title_short | The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients |
| title_sort | association between the decline of egfr and a reduction of hemoglobin a1c in type 2 diabetic patients |
| topic | diabetes type 2 hemoglobin A1c (HbA1c) estimated glomerular filtration rate (eGFR) hyperfiltration |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.723720/full |
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