Metabolic risk factors in nondiabetic adolescents with glomerular hyperfiltration

Lee, Arthur M.; Charlton, Jennifer R.; Carmody, John; Gurka, Matthew J.; DeBoer, Mark D.

doi:10.1093/ndt/gfw231

Cited by 16 publications

(19 citation statements)

References 64 publications

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“…These findings were surprising and may be hypothesis generating. One hypothesis is that this reflects hyperfiltration, in which the kidney compensates for increased metabolic demands, as noted in obesity[35], insulin resistance[36], MetS[37], and subclinical CVD[38]. This could increase GFR, with initial decrease in CKD.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome Severity and Risk of CKD and Worsened GFR: The Jackson Heart Study

DeBoer

Filipp

Musani

et al. 2018

Kidney Blood Press Res

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Background/Aims: The metabolic syndrome (MetS), as assessed using dichotomous criteria, is associated with increased risk of future chronic kidney disease (CKD), though this relationship is unclear among African Americans, who have lower risk for MetS but higher risk for CKD. Methods: We performed logistic regression using a sex- and race-specific MetS-severity z-score to assess risk of incident CKD among 2,627 African-American participants of the Jackson Heart Study, assessed at baseline and 8 years later. Based on quartile of baseline MetS severity, we further assessed prevalence of being in the lowest quartile of baseline GFR, the lowest quartile of relative GFR at follow-up, microalbuminuria and incident CKD. Results: Higher MetS-severity was associated with higher prevalence of GFR in the lowest quartile at baseline among males and females. Among African-American females but not males, higher baseline MetS-severity was associated with a higher prevalence of baseline elevations in microabuminuria (p<0.01), steep decline in GFR (p<0.001) and a higher incidence of CKD (p<0.0001). Women in increasing quartiles of baseline MetS-severity exhibited a linear trend toward higher odds of future CKD (p<0.05), with those in the 4^th quartile of MetS-severity (compared to the 1^st) having an odds ratio of 2.47 (95% confidence interval 1.13, 5.37); no such relationship was seen among men (p value for trend 0.49). Conclusion: MetS-severity exhibited sex-based interactions regarding risk for future GFR deterioration and CKD, with increasing risk in women but not men. These data may have implications for triggering CKD screening among African-American women with higher degrees of MetS-severity.

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Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome Severity and Risk of CKD and Worsened GFR: The Jackson Heart Study

DeBoer

Filipp

Musani

et al. 2018

Kidney Blood Press Res

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“… 23 Moreover, a cross-sectional study of 2584 men and women aged 12–17 years showed that persons with glomerular hyperfiltration (estimated glomerular filtration rate (eGFR)≥120 mL/min 1.73 m 2 ) had higher mean levels of fasting insulin after adjusting for BMI. 24 In that study, eGFR was defined by the Schwartz equation, that is, eGFR (mL/min 1.73 m 2 )=0.413×height (cm)/serum creatinine (mg/dL), so another possibility is that glomerular hyperfiltration led to low serum creatinine levels.…”

Section: Discussionmentioning

confidence: 99%

Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study

Takeuchi

Imano

Muraki

et al. 2018

BMJ Open Diab Res Care

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ObjectiveTo assess the association between low serum creatinine levels and an increased risk of type 2 diabetes mellitus and dysglycemia.Research design and methodsWe conducted a retrospective cohort study of 3313 Japanese male workers aged 30–55 years, who underwent annual health check-ups during 2001–2008 and showed no type 2 diabetes mellitus, and underwent follow-up examinations until March 2013. Dysglycemia was defined as a fasting plasma glucose concentration of ≥110 mg/dL (6.1 mmol/L), or a non-fasting plasma glucose concentration of ≥140 mg/dL (7.8 mmol/L). A Cox proportional model was used to calculate HRs and 95% CIs for developing type 2 diabetes mellitus or dysglycemia.ResultsDuring the median 6.7-year follow-up, there were 207 cases of incident type 2 diabetes mellitus and 596 cases of incident dysglycemia, including 115 cases of type 2 diabetes mellitus among the subjects with normal glucose concentrations at baseline. After adjustment for age, body mass index and known diabetes risk factors, the multivariable HR of type 2 diabetes mellitus for the lowest category of serum creatinine (<0.7 mg/dL) vs the highest category (0.9–1.1 mg/dL) was 1.9 (95% CI 1.2 to 2.9; P for trend 0.03). The multivariable HRs of dysglycemia for the lowest category of serum creatinine versus the highest category was 1.5 (95% CI 1.1 to 1.9; P for trend 0.01).ConclusionsLow serum creatinine levels were associated with an increased risk of type 2 diabetes mellitus and dysglycemia.

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“…This underscores an enormous risk for future T2DM and CVD based on prevalence of risk factors in the current generation of US adolescents. In addition, MetS is also linked to other obesity-related disease processes, including non-alcoholic fatty liver disease (NAFLD) [51] and renal function [52], with implications for chronic kidney disease [53].…”

Section: Long-term Risksmentioning

confidence: 99%

Assessing and Managing the Metabolic Syndrome in Children and Adolescents

2019

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The metabolic syndrome (MetS) is a group of cardiovascular risk factors that are associated with insulin resistance and are driven by underlying factors, including visceral obesity, systemic inflammation, and cellular dysfunction. These risks increasingly begin in childhood and adolescence and are associated with a high likelihood of future chronic disease in adulthood. Efforts should be made at both recognition of this metabolic risk, screening for potential associated Type 2 diabetes, and targeting affected individuals for appropriate treatment with an emphasis on lifestyle modification. Effective interventions have been linked to reductions in MetS—and in adults, reductions in the severity of MetS have been linked to reduced diabetes and cardiovascular disease.

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Metabolic risk factors in nondiabetic adolescents with glomerular hyperfiltration

Cited by 16 publications

References 64 publications

Metabolic Syndrome Severity and Risk of CKD and Worsened GFR: The Jackson Heart Study

Metabolic Syndrome Severity and Risk of CKD and Worsened GFR: The Jackson Heart Study

Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study

Assessing and Managing the Metabolic Syndrome in Children and Adolescents

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