TY - JOUR
T1 - Strong Negative Association of non-HDL Cholesterol Goal Achievement With Incident CKD Among Adults With Diabetes
AU - Gnecco-González, Sofía
AU - Amaya-Montoya, Mateo
AU - Herrera-Parra, Lina J
AU - Hernández Vargas, Juliana A
AU - Ramírez-García, Nathaly
AU - Romero-Díaz, Camila
AU - Acuña-Merchán, Lizbeth
AU - Mendivil, Carlos O
N1 - Publisher Copyright:
© 2022 The Author(s).
PY - 2023/3
Y1 - 2023/3
N2 - CONTEXT: The relative importance of the control of different metabolic risk factors for the prevention of chronic kidney disease among patients with diabetes in real life conditions is insufficiently understood.OBJECTIVE: We evaluated the effect of the achievement of glycated hemoglobin A
1c (HbA
1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDLc) or non-high-density lipoprotein cholesterol (non-HDLc) goals (ABC goals) on the development of incident chronic kidney disease (iCKD) among patients with diabetes.
METHODS: In a nationwide registry of all individuals diagnosed with diabetes assisted by the health system in Colombia, we analyzed the association between baseline or sustained goal achievement and development of iCKD over a 4-year follow-up. iCKD was defined as a new occurrence of an estimated glomerular filtration rate less than 60 mL/min/1.73 m
2, hemodialysis, peritoneal dialysis, or kidney transplant.
RESULTS: The study included 998 790 adults with diabetes (56% female, mean age 59). There were 125 626 cases of iCKD. After adjustment for multiple confounders, a baseline SBP less than 130 mm Hg (odds ratio [OR] 0.79 [0.78-0.80]) and a baseline HbA
1c less than 7.0% (OR 0.86 [0.85-0.87]) were negatively associated with iCKD. Sustained achievement showed stronger negative associations with iCKD than just baseline achievement. Considering each goal separately, sustained non-HDLc less than 130 mg/dL had the strongest negative association with iCKD (OR 0.67 [0.65-0.69]). Patients who maintained the triple ABC goal over the entire follow-up had 32% (29-34) lower odds of developing CKD, 38% (34-42) if they additionally kept a normal body mass index (BMI). Sustained ABC control including a normal BMI was more strongly associated with a lower incidence of CKD in patients of Black race (OR 0.72 vs 0.89;
P for interaction = .002).
CONCLUSION: At the country level, sustained achievement of ABC goals and most especially non-HDLc were associated with substantial reductions in iCKD.
AB - CONTEXT: The relative importance of the control of different metabolic risk factors for the prevention of chronic kidney disease among patients with diabetes in real life conditions is insufficiently understood.OBJECTIVE: We evaluated the effect of the achievement of glycated hemoglobin A
1c (HbA
1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDLc) or non-high-density lipoprotein cholesterol (non-HDLc) goals (ABC goals) on the development of incident chronic kidney disease (iCKD) among patients with diabetes.
METHODS: In a nationwide registry of all individuals diagnosed with diabetes assisted by the health system in Colombia, we analyzed the association between baseline or sustained goal achievement and development of iCKD over a 4-year follow-up. iCKD was defined as a new occurrence of an estimated glomerular filtration rate less than 60 mL/min/1.73 m
2, hemodialysis, peritoneal dialysis, or kidney transplant.
RESULTS: The study included 998 790 adults with diabetes (56% female, mean age 59). There were 125 626 cases of iCKD. After adjustment for multiple confounders, a baseline SBP less than 130 mm Hg (odds ratio [OR] 0.79 [0.78-0.80]) and a baseline HbA
1c less than 7.0% (OR 0.86 [0.85-0.87]) were negatively associated with iCKD. Sustained achievement showed stronger negative associations with iCKD than just baseline achievement. Considering each goal separately, sustained non-HDLc less than 130 mg/dL had the strongest negative association with iCKD (OR 0.67 [0.65-0.69]). Patients who maintained the triple ABC goal over the entire follow-up had 32% (29-34) lower odds of developing CKD, 38% (34-42) if they additionally kept a normal body mass index (BMI). Sustained ABC control including a normal BMI was more strongly associated with a lower incidence of CKD in patients of Black race (OR 0.72 vs 0.89;
P for interaction = .002).
CONCLUSION: At the country level, sustained achievement of ABC goals and most especially non-HDLc were associated with substantial reductions in iCKD.
U2 - 10.1210/jendso/bvac193
DO - 10.1210/jendso/bvac193
M3 - Article
C2 - 36632486
SN - 2472-1972
VL - 7
JO - JOURNAL OF THE ENDOCRINE SOCIETY
JF - JOURNAL OF THE ENDOCRINE SOCIETY
IS - 3
M1 - bvac193
ER -