Introduction & Objective:<u></u> Low birthweight (BW), a proxy for an adverse intrauterine environment, has been associated with risk of type 2 diabetes (T2D) and chronic kidney disease (CKD) later in life. The extent to which lower birthweight among people with T2D increases risk of CKD is unknown.

Methods: Original midwife records were reviewed for 5979 people recently diagnosed with T2D in the Danish Center for Strategic Research in T2D (DD2) cohort. Individuals were followed for the incidence of CKD, defined by 1) two eGFR values <60ml/min per 1.73m2, 90 to 365 days apart, or 2) two urine albumin/creatinine ratios >30mg/g, 90 to 365 days apart. Ten-year standardized risks of CKD were estimated by the parametric G-formula using the Aalen-Johansen estimator, considering death as a competing risk. Adjusted hazard ratios (aHRs) were computed using Cox regression analysis. Continuous relations between BW and incident CKD were assessed with linear and restricted cubic spline regression. All models were standardized or adjusted for sex, age, calendar year at birth, family history of diabetes, and born-at-term status.

Results: A total of 1443 incident CKD outcomes occurred in people with T2D during median follow-up of 8.5 years. Spline models showed progressively increasing aHRs of CKD with successively lower BW. The 10-year standardized risk of CKD was 39.9% in people with low BW <2500 g, compared with 33.5% in people with a BW of 2500-4500 g, yielding a CKD risk difference of 6.4% (95% CI: -0.3, 13.3) and an aHR of 1.25 (95% CI: 0.99, 1.58). People with T2D and a high BW >4500 g, compared with a BW of 2500-4500 g, had similar 10-year standardized CKD risks of 31.7% vs. 33.5%, respectively, corresponding to an aHR of 0.93 (95% CI: 0.59, 1.47).

Conclusion: Lower birthweight is associated with elevated risk of CKD among people with type 2 diabetes.

Disclosure

A. Lühr Hansen: None. C. Christiansen: None. C. Brøns: Stock/Shareholder; Novo Nordisk A/S. L.M. Engelhard: None. T. Hansen: None. J.S. Nielsen: None. P. Vestergaard: None. K. Hojlund: None. N. Jessen: None. M. Olsen: Other Relationship; AstraZeneca, Novo Nordisk A/S. Advisory Panel; Novo Nordisk A/S. Other Relationship; Teva Pharmaceutical Industries Ltd. H.T. Sørensen: Other Relationship; See text. P. Rossing: Other Relationship; AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Gilead Sciences, Inc., Novo Nordisk, Eli Lilly and Company, Novartis AG, Abbott Diagnostics. R.W. Thomsen: None. A.A. Vaag: None.

Funding

Danish Agency for Science (09-067009 and 09-075724); Novo Nordisk Foundation ( NNF17SA0030962-2, NNF20O0063292, NNF17SA0030364)

© 2024 by the American Diabetes Association
2024
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