Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus
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 r...
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Korean Diabetes Association
2021
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oai:doaj.org-article:0f7a5f3b56ee4beb8dc3afa6d90a0acb2021-12-01T05:07:51ZAssociations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus2233-60792233-608710.4093/dmj.2020.0149https://doaj.org/article/0f7a5f3b56ee4beb8dc3afa6d90a0acb2021-11-01T00:00:00Zhttp://www.e-dmj.org/upload/pdf/dmj-2020-0149.pdfhttps://doaj.org/toc/2233-6079https://doaj.org/toc/2233-6087Background 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.Hua-Xing HuangLiang-Lan ShenHai-Yan HuangLi-Hua ZhaoFeng XuDong-Mei ZhangXiu-Lin ZhangTong ChenXue-Qin WangYan XieJian-Bin SuKorean Diabetes Associationarticlediabetes mellitus, type 2diabetic nephropathiesglucagonDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENDiabetes & Metabolism Journal, Vol 45, Iss 6, Pp 868-879 (2021) |
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diabetes mellitus, type 2 diabetic nephropathies glucagon Diseases of the endocrine glands. Clinical endocrinology RC648-665 |
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diabetes mellitus, type 2 diabetic nephropathies glucagon Diseases of the endocrine glands. Clinical endocrinology RC648-665 Hua-Xing Huang Liang-Lan Shen Hai-Yan Huang Li-Hua Zhao Feng Xu Dong-Mei Zhang Xiu-Lin Zhang Tong Chen Xue-Qin Wang Yan Xie Jian-Bin Su Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus |
| description |
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. |
| format |
article |
| author |
Hua-Xing Huang Liang-Lan Shen Hai-Yan Huang Li-Hua Zhao Feng Xu Dong-Mei Zhang Xiu-Lin Zhang Tong Chen Xue-Qin Wang Yan Xie Jian-Bin Su |
| author_facet |
Hua-Xing Huang Liang-Lan Shen Hai-Yan Huang Li-Hua Zhao Feng Xu Dong-Mei Zhang Xiu-Lin Zhang Tong Chen Xue-Qin Wang Yan Xie Jian-Bin Su |
| author_sort |
Hua-Xing Huang |
| title |
Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus |
| title_short |
Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus |
| title_full |
Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus |
| title_fullStr |
Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus |
| title_full_unstemmed |
Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus |
| title_sort |
associations of plasma glucagon levels with estimated glomerular filtration rate, albuminuria and diabetic kidney disease in patients with type 2 diabetes mellitus |
| publisher |
Korean Diabetes Association |
| publishDate |
2021 |
| url |
https://doaj.org/article/0f7a5f3b56ee4beb8dc3afa6d90a0acb |
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