386-P: eGFR, Cardiometabolic, and Prediabetes Risk in Healthy Subjects

Introduction and Objective: We examined kidney function (eGFR) in relation to cardiometabolic risk factors (CMRFs) and incident prediabetes in healthy subjects.

Methods: Participants were normoglycemic Black and White offspring of parents with type 2 diabetes followed for 5 years in the POP-ABC study. Assessments included clinical exam, OGTT, chemistries, lipids, insulin sensitivity (ISI, by euglycemic clamp), insulin secretion (AIRg) and disposition index (DI=AIRg x ISI). The CKD-EPI equation was used to estimate eGFR (ml/min/1.73m²) at baseline. Participants were grouped by the presence of 3 or more metabolic syndrome (MetS)components into MetS or NonMetS groups.

Results: We studied 296 subjects (73% female; 138 Black, 158 White), mean age 45.5 ± 10.1 yr, and BMI 30.5 ± 7.6 kg/m². Individuals with MetS had higher baseline eGFR versus NonMetS (112 ± 18.2 vs. 101 ± 18.4, P= 0.0002). eGFR correlated with waist circumference (men: r=0.26, P=0.02; women: r=0.40, P<0.0001) and HDL (women: r= -0.42, P<.0001; men: r= -0.17; P=0.106), but not systolic BP (r=0.06, P=0.32), diastolic BP (r=0.07, P=0.23), or triglycerides (r=0.06, P=0.30). eGFR levels increased with cumulative MetS components (P_ANOVA= 0.0002). Baseline eGFR values were significantly higher in participants who progressed to prediabetes during 5-yr follow-up vs. nonprogressors (107 ± 18.5 vs. 100 ± 18.5, P=0.003) and significantly associated with incident prediabetes (Z= -14.9, P<0.0001).

Conclusion: Among healthy persons with normal glucose and eGFR levels, we observed a significant association between eGFR and some cardiometabolic risk markers and incident prediabetes. Thus, variations in eGFR within the normal reference range among healthy people might convey significant cardiometabolic information. Further studies are needed to unravel the mechanisms linking variations within normal eGFR range and metabolic dysregulation.