Association between continuous glucose monitoring-derived glycemic control indices and urinary biomarkers of diabetic kidney disease: Hyogo Diabetes Hypoglycemia Cognition Complications study.

Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE

Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1991-

Diabetic Nephropathies*/etiology ; Diabetic Nephropathies*/complications ; Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/urine ; Hypoglycemia*/complications; Humans ; Albuminuria/complications ; Retrospective Studies ; Blood Glucose ; Creatinine/urine ; Cross-Sectional Studies ; Blood Glucose Self-Monitoring/adverse effects ; Continuous Glucose Monitoring ; Glycemic Control/adverse effects ; Biomarkers/urine

Aims: Glomerular damage and proximal tubular damage play an important role in the pathogenesis of diabetic kidney disease. This study aimed to investigate the relationship between the urinary markers of proximal tubular injury, including urinary liver-type fatty acid-binding protein-to-creatinine ratio (uL-FABP/Cr) and urinary N-acetyl-β-D-glucosaminidase-to-creatinine ratio (uNAG/Cr), and glycemic control status.
Methods: This cross-sectional study included 245 and 39 patients with type 2 diabetes mellitus (T2DM) and non-T2DM (NDM), respectively. The participants of this study were fitted with retrospective CGM, and glycemic control indices, such as time in range (TIR) and glycemia risk index (GRI), were calculated.
Results: The results were presented as medians (interquartile ranges). The uL-FABP/Cr was significantly higher in the microalbuminuria than in the normo-albuminuria group [4.2 (2.7-7.1) and 2.2 (1.4-3.4) μg/gCr, respectively, P < 0.001], while the uNAG/Cr in the normo-albuminuria group [6.3 (4.5-10.1) U/gCr] was significantly higher than that in the NDM group [5.3 (3.8-6.3) U/gCr, P = 0.048] but significantly lower than that in the microalbuminuria group [9.2 (6.4-11.1) U/gCr, P = 0.004]. The multivariate logistic regression analysis indicated that CGM-derived TIR was significantly associated with the urinary albumin-to-creatinine ratio [uAlb/Cr, odds ratio (OR) 0.985, 95% confidence interval (CI) 0.971-0.998, P = 0.029] and uNAG/Cr (OR 0.973, 95% CI 0.957-0.989, P = 0.001) independent of renal function. GRI was similarly associated with uAlb/Cr and uNAG/Cr.
Conclusion: The findings of this study indicated that uNAG/Cr was elevated before albuminuria development and was associated with CGM-derived TIR and GRI.
(© 2023. The Author(s).)

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22K10541 Japan Society for the Promotion of Science; 21K17297 Japan Society for the Promotion of Science

Keywords: Continuous glucose monitoring; Glycemia risk index; Time in range; Urinary N-acetyl-β-d-glucosaminidase; Urinary albumin

0 (Blood Glucose)
AYI8EX34EU (Creatinine)
0 (Biomarkers)

Date Created: 20231125 Date Completed: 20240327 Latest Revision: 20240328

20240329

PMC10963564

10.1007/s00592-023-02214-9

38006524