A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults

Abstract Chronic kidney disease (CKD) is a major global public health problem. Recent studies reported that diabetes and prediabetes are risk factors for developing CKD; however, the exact glycated hemoglobin (HbA1c) cut-off value for prediabetes remains controversial. In this study, we aimed to exa...

Full description

Bibliographic Details
Main Authors: Yukari Okawa, Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Takashi Yorifuji
Format: Article
Language:English
Published: Nature Portfolio 2023-08-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-023-40300-8
_version_ 1797452729061212160
author Yukari Okawa
Etsuji Suzuki
Toshiharu Mitsuhashi
Toshihide Tsuda
Takashi Yorifuji
author_facet Yukari Okawa
Etsuji Suzuki
Toshiharu Mitsuhashi
Toshihide Tsuda
Takashi Yorifuji
author_sort Yukari Okawa
collection DOAJ
description Abstract Chronic kidney disease (CKD) is a major global public health problem. Recent studies reported that diabetes and prediabetes are risk factors for developing CKD; however, the exact glycated hemoglobin (HbA1c) cut-off value for prediabetes remains controversial. In this study, we aimed to examine the relationship between HbA1c levels and subsequent CKD development in greater detail than previous studies. Longitudinal data of annual checkups of 7176 Japanese non-diabetic people (male: 40.4%) from 1998 to 2022 was analyzed. HbA1c values were categorized into < 5.0%, 5.0–5.4%, 5.5–5.9%, and 6.0–6.4%. CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m2. The descriptive statistics at study entry showed that higher HbA1c values were associated with male, older, overweight or obese, hypertensive, or dyslipidemic people. During a mean follow-up of 7.75 person-years, 2374 participants (male: 40.0%) developed CKD. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated. The adjusted time ratios of developing CKD for HbA1c levels of 5.5–5.9% and 6.0–6.4% compared with 5.0–5.4% were 0.97 (95% confidence interval: 0.92–1.03) and 1.01 (95% confidence interval: 0.90–1.13), respectively. There was no association between HbA1c in the prediabetic range and subsequent CKD development.
first_indexed 2024-03-09T15:12:52Z
format Article
id doaj.art-8bc86f6b12504df58f82b72130db3d76
institution Directory Open Access Journal
issn 2045-2322
language English
last_indexed 2024-03-09T15:12:52Z
publishDate 2023-08-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj.art-8bc86f6b12504df58f82b72130db3d762023-11-26T13:17:12ZengNature PortfolioScientific Reports2045-23222023-08-0113111310.1038/s41598-023-40300-8A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adultsYukari Okawa0Etsuji Suzuki1Toshiharu Mitsuhashi2Toshihide Tsuda3Takashi Yorifuji4Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCenter for Innovative Clinical Medicine, Okayama University HospitalDepartment of Human Ecology, Graduate School of Environmental and Life Science, Okayama UniversityDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAbstract Chronic kidney disease (CKD) is a major global public health problem. Recent studies reported that diabetes and prediabetes are risk factors for developing CKD; however, the exact glycated hemoglobin (HbA1c) cut-off value for prediabetes remains controversial. In this study, we aimed to examine the relationship between HbA1c levels and subsequent CKD development in greater detail than previous studies. Longitudinal data of annual checkups of 7176 Japanese non-diabetic people (male: 40.4%) from 1998 to 2022 was analyzed. HbA1c values were categorized into < 5.0%, 5.0–5.4%, 5.5–5.9%, and 6.0–6.4%. CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m2. The descriptive statistics at study entry showed that higher HbA1c values were associated with male, older, overweight or obese, hypertensive, or dyslipidemic people. During a mean follow-up of 7.75 person-years, 2374 participants (male: 40.0%) developed CKD. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated. The adjusted time ratios of developing CKD for HbA1c levels of 5.5–5.9% and 6.0–6.4% compared with 5.0–5.4% were 0.97 (95% confidence interval: 0.92–1.03) and 1.01 (95% confidence interval: 0.90–1.13), respectively. There was no association between HbA1c in the prediabetic range and subsequent CKD development.https://doi.org/10.1038/s41598-023-40300-8
spellingShingle Yukari Okawa
Etsuji Suzuki
Toshiharu Mitsuhashi
Toshihide Tsuda
Takashi Yorifuji
A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults
Scientific Reports
title A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults
title_full A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults
title_fullStr A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults
title_full_unstemmed A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults
title_short A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults
title_sort population based longitudinal study on glycated hemoglobin levels and new onset chronic kidney disease among non diabetic japanese adults
url https://doi.org/10.1038/s41598-023-40300-8
work_keys_str_mv AT yukariokawa apopulationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT etsujisuzuki apopulationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT toshiharumitsuhashi apopulationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT toshihidetsuda apopulationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT takashiyorifuji apopulationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT yukariokawa populationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT etsujisuzuki populationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT toshiharumitsuhashi populationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT toshihidetsuda populationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults
AT takashiyorifuji populationbasedlongitudinalstudyonglycatedhemoglobinlevelsandnewonsetchronickidneydiseaseamongnondiabeticjapaneseadults