Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?

<h4>Objective</h4>Estimation of glomerular filtration rate (eGFR) is one of the current clinical methods for identifying risk for diabetic nephropathy in subjects with type 1 diabetes (T1D). Hyperglycemia is known to influence GFR in T1D and variability in blood glucose at the time of eG...

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Autores principales:	Petter Bjornstad, R Brett McQueen, Janet K Snell-Bergeon, David Cherney, Laura Pyle, Bruce Perkins, Marian Rewers, David M Maahs
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/de4a7965afa04366a078b3146f16e5b6
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spelling	oai:doaj.org-article:de4a7965afa04366a078b3146f16e5b62021-11-18T08:21:22ZFasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?1932-620310.1371/journal.pone.0096264https://doaj.org/article/de4a7965afa04366a078b3146f16e5b62014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24781861/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Estimation of glomerular filtration rate (eGFR) is one of the current clinical methods for identifying risk for diabetic nephropathy in subjects with type 1 diabetes (T1D). Hyperglycemia is known to influence GFR in T1D and variability in blood glucose at the time of eGFR measurement could introduce bias in eGFR. We hypothesized that simultaneously measured blood glucose would influence eGFR in adults with T1D.<h4>Methods</h4>Longitudinal multivariable mixed-models were employed to investigate the relationships between blood glucose and eGFR by CKD-EPI eGFRCYSTATIN C over 6-years in the Coronary Artery Calcification in Type 1 diabetes (CACTI) study. All subjects with T1D and complete data including blood glucose and cystatin C for at least one of the three visits (n = 616, 554, and 521, respectively) were included in the longitudinal analyses.<h4>Results</h4>In mixed-models adjusting for sex, HbA1c, ACEi/ARB, protein and sodium intake positive associations were observed between simultaneous blood glucose and eGFRCYSTATIN C (β±SE:0.14±0.04 per 10 mg/dL of blood glucose, p<0.0001), and hyperfiltration as a dichotomous outcome (OR: 1.04, 95% CI: 1.01-1.07 per 10 mg/dL of blood glucose, p = 0.02).<h4>Conclusions</h4>In our longitudinal data in subjects with T1D, simultaneous blood glucose has an independent positive effect on eGFRCYSTATIN C. The associations between blood glucose and eGFRCYSTATIN C may bias the accurate detection of early diabetic nephropathy, especially in people with longitudinal variability in blood glucose.Petter BjornstadR Brett McQueenJanet K Snell-BergeonDavid CherneyLaura PyleBruce PerkinsMarian RewersDavid M MaahsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e96264 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Petter Bjornstad R Brett McQueen Janet K Snell-Bergeon David Cherney Laura Pyle Bruce Perkins Marian Rewers David M Maahs Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?
description	<h4>Objective</h4>Estimation of glomerular filtration rate (eGFR) is one of the current clinical methods for identifying risk for diabetic nephropathy in subjects with type 1 diabetes (T1D). Hyperglycemia is known to influence GFR in T1D and variability in blood glucose at the time of eGFR measurement could introduce bias in eGFR. We hypothesized that simultaneously measured blood glucose would influence eGFR in adults with T1D.<h4>Methods</h4>Longitudinal multivariable mixed-models were employed to investigate the relationships between blood glucose and eGFR by CKD-EPI eGFRCYSTATIN C over 6-years in the Coronary Artery Calcification in Type 1 diabetes (CACTI) study. All subjects with T1D and complete data including blood glucose and cystatin C for at least one of the three visits (n = 616, 554, and 521, respectively) were included in the longitudinal analyses.<h4>Results</h4>In mixed-models adjusting for sex, HbA1c, ACEi/ARB, protein and sodium intake positive associations were observed between simultaneous blood glucose and eGFRCYSTATIN C (β±SE:0.14±0.04 per 10 mg/dL of blood glucose, p<0.0001), and hyperfiltration as a dichotomous outcome (OR: 1.04, 95% CI: 1.01-1.07 per 10 mg/dL of blood glucose, p = 0.02).<h4>Conclusions</h4>In our longitudinal data in subjects with T1D, simultaneous blood glucose has an independent positive effect on eGFRCYSTATIN C. The associations between blood glucose and eGFRCYSTATIN C may bias the accurate detection of early diabetic nephropathy, especially in people with longitudinal variability in blood glucose.
format	article
author	Petter Bjornstad R Brett McQueen Janet K Snell-Bergeon David Cherney Laura Pyle Bruce Perkins Marian Rewers David M Maahs
author_facet	Petter Bjornstad R Brett McQueen Janet K Snell-Bergeon David Cherney Laura Pyle Bruce Perkins Marian Rewers David M Maahs
author_sort	Petter Bjornstad
title	Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?
title_short	Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?
title_full	Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?
title_fullStr	Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?
title_full_unstemmed	Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?
title_sort	fasting blood glucose--a missing variable for gfr-estimation in type 1 diabetes?
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/de4a7965afa04366a078b3146f16e5b6
work_keys_str_mv	AT petterbjornstad fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT rbrettmcqueen fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT janetksnellbergeon fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT davidcherney fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT laurapyle fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT bruceperkins fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT marianrewers fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes AT davidmmaahs fastingbloodglucoseamissingvariableforgfrestimationintype1diabetes
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Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?

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