Objectives: We investigated associations between HGI and incident chronic kidney disease (CKD) in treatment naïve subjects with prediabetes or diabetes.

Methods: A prospective cohort study was conducted in 2,187 subjects with prediabetes or diabetes. The HGI was calculated as the measured HbA1c minus predicted HbA1c, which was calculated from the linear relationship between HbA1c and fasting plasma glucose levels. Incident CKD was defined as occurring if eGFR decreased to less than 60 mL/min per 1.73 m2 and decreased by more than 25% from baseline during follow-up. The hazard ratio (HR) for incident CKD was calculated using Cox models.

Results: The overall prevalence of CKD was 335 (15.3%) during the 10-year follow-up period. While the prevalences of CKD significantly increased from the first to third tertile of HGI, this phenomenon was not seen in HbA1c (Figure). In multivariate analysis, the highest HGI tertile group showed the highest adjusted HR for incident CKD (HR, 1.57; 95% CI, 1.06-2.34) and this was significant even after adjustment for HbA1c.

Conclusion: High HGI was associated with increased risk for incident CKD in treatment naïve subjects with prediabetes or diabetes. These finding suggest that HGI might provide additional information for predicting CKD in patients with impaired glucose tolerance independently of HbA1c levels.


J. Huh: None. W. Kim: None. M. Kim: None.

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