Prevalence of chronic kidney disease across levels of glycemia among adults in Pudong New Area, Shanghai, China

BMC Nephrology

Qiao Sun³  K M Venkat Narayan²  Hua Qiu³  Hong Zhang³  Li-ming Yang³  Wang-hong Xu¹  Gen-ming Zhao¹  Xiao-nan Ruan³  Jian-jun Gu⁴  Justin B Echouffo-Tcheugui²  Yi Zhou³ 

[1] Key Laboratory of Public Health Safety, Ministry of Education (Fudan University), 138 Yi Xue Yuan Road, Shanghai 200032, China;Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA;Pudong New Area Center for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, China;Health Bureau of Shanghai Pudong New Area, 820 Cheng Shan Road, Shanghai 200125, China

关键词: Epidemiology;    Glycemia;    Chronic kidney disease;   

Others  :  1082786
DOI  :  10.1186/1471-2369-14-253

 received in 2013-08-17, accepted in 2013-11-12,  发布年份 2013

【 摘 要 】

Background

Few population-based studies have examined the relationship between glycemic status and chronic kidney disease (CKD) in China. We examined the prevalence of CKD across categories of glycemia [diagnosed diabetes, undiagnosed diabetes (fasting plasma glucose [FPG] ≥ 126 mg/dL), prediabetes (FPG 100–126 mg/dL) and normal glycemia (FPG <100 mg/dL)] among Chinese adults and assessed the relative contribution of dysglycemia (prediabetes and/or diabetes) to the burden of CKD.

Methods

5,584 Chinese adults aged 20–79 years were selected from the Pudong New Area of Shanghai through a multistage random sampling. Demographic and lifestyle characteristics, anthropometry and blood pressure were measured. Biochemical assays included FPG, serum creatinine and lipids, urinary creatinine and albumin. Prevalence of albuminuria [urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g], decreased kidney function and CKD (either decreased kidney function or albuminuria) across levels of glycemia were estimated.

Results

The prevalence of albuminuria, decreased kidney function and CKD each increased with higher glycemic levels (P < 0.001). Based on the MDRD Study equation, the unadjusted CKD prevalence was 30.9%, 28.5%, 14.1% and 9.2% in those with diagnosed diabetes, undiagnosed diabetes, prediabetes and normoglycemia, respectively. The corresponding age-, gender- and hypertension-adjusted CKD prevalence were 25.8%, 25.0%, 12.3% and 9.1%, respectively. In a multivariable analysis, the factors associated with CKD were hypertension (Odds ratio [OR] 1.70, 95% confidence interval [CI]: 1.42-2.03), dysglycemia (OR 1.65, 95% CI: 1.39-1.95), female gender (OR 1.48, 95% CI: 1.25-1.75), higher triglycerides (OR 1.14, 95% CI: 1.08-1.20 per mmol/L), higher body mass index (OR 1.08, 95% CI: 1.05-1.10 per kg/m2), and older age (OR 1.02, 95% CI: 1.01 -1.03 per year). The population attributable risks (PARs) associated with diabetes, prediabetes, dysglycemia (diabetes and prediabetes) and hypertension were 18.4%, 19.7%, 30.3% and 44.5% for CKD as defined by the MDRD study equation, and 15.8%, 24.4%, 29.2% and 10.0% with the CKD-EPI equation. Estimates of prevalence and ORs of the relative contribution of various risk factors to CKD obtained with the CKD-EPI equation were similar.

Conclusions

As much as 30% of the CKD burden may be associated with dysglycemia among Chinese adults, independent of age, gender and hypertension status. Prevention and control of diabetes and prediabetes should be a high priority in reducing the CKD burden in China.

【 授权许可】

   
2013 Zhou et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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