PMID- 30565819
OWN - NLM
STAT- MEDLINE
DCOM- 20200227
LR  - 20221207
IS  - 1440-1797 (Electronic)
IS  - 1320-5358 (Linking)
VI  - 24
IP  - 10
DP  - 2019 Oct
TI  - Impact of haemoglobin A1c trajectories on chronic kidney disease progression in 
      type 2 diabetes.
PG  - 1026-1032
LID - 10.1111/nep.13533 [doi]
AB  - AIM: To characterize haemoglobin A1c (HbA1c) trajectories and examine their 
      associations with chronic kidney disease (CKD) progression. METHODS: This was a 
      prospective cohort study on 770 patients with type 2 diabetes mellitus (T2DM) 
      attending a diabetes centre in 2002-2017. Group-based trajectory modelling was 
      used to identify HbA1c trajectories. Cox proportional hazards models were used to 
      examine association between the trajectories and CKD progression which was 
      defined as deterioration across the Kidney Disease: Improving Global Outcomes 
      estimated glomerular filtration rate categories with >/=25% drop from baseline. 
      RESULTS: We identified four HbA1c trajectories: 'near-optimal stable' (49.1%), 
      'moderate stable' (37.9%), 'moderate-increasing' (6.0%) and 'high-decreasing' 
      (7.0%). Over a median follow-up period of 4.6 years (interquartile range 
      2.5-5.6), CKD progression occurred in 35.6% of patients. The risk of CKD 
      progression was significantly higher in the moderate-increasing with adjusted 
      hazard ratios (HR) 2.23 (95% confidence interval (CI) 1.09-4.57). After 
      additional adjustment for mean HbA1c, the association between the 
      moderate-increasing subgroup and CKD progression remained significant at HR 3.07 
      (95% CI 1.08-8.77). CONCLUSION: Moderate-increasing HbA1c trajectory is 
      associated with renal disease progression in patients with T2DM, independent of 
      mean HbA1c. The deleterious effects of deteriorating HbA1c trajectory highlight 
      the importance of achieving sustained good glycaemic control in diabetes 
      management.
CI  - (c) 2018 Asian Pacific Society of Nephrology.
FAU - Low, Serena
AU  - Low S
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore.
FAU - Zhang, Xiao
AU  - Zhang X
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore.
FAU - Wang, Jiexun
AU  - Wang J
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore.
FAU - Yeoh, Lee Y
AU  - Yeoh LY
AD  - Department of Medicine, Sengkang General Hospital, Singapore, Singapore.
FAU - Liu, Yan L
AU  - Liu YL
AD  - Department of Medicine, Khoo Teck Puat Hospital, Yishun, Singapore.
FAU - Ang, Su F
AU  - Ang SF
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore.
FAU - Subramaniam, Tavintharan
AU  - Subramaniam T
AD  - Diabetes Centre, Khoo Teck Puat Hospital, Singapore, Singapore.
FAU - Sum, Chee F
AU  - Sum CF
AD  - Diabetes Centre, Khoo Teck Puat Hospital, Singapore, Singapore.
FAU - Lim, Su C
AU  - Lim SC
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore.
AD  - Diabetes Centre, Khoo Teck Puat Hospital, Singapore, Singapore.
AD  - Saw Swee Hock School of Public Health, National University of Singapore, 
      Singapore, Singapore.
LA  - eng
GR  - AHPL SIG II/11001/Alexandra Health Fund Limited/
GR  - SIG/11029/Alexandra Health Fund Limited/
GR  - SIG/12024/Alexandra Health Fund Limited/
PT  - Journal Article
DEP - 20190502
PL  - Australia
TA  - Nephrology (Carlton)
JT  - Nephrology (Carlton, Vic.)
JID - 9615568
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Cohort Studies
MH  - *Diabetes Mellitus, Type 2/blood/complications/diagnosis/epidemiology
MH  - *Diabetic Nephropathies/blood/diagnosis/epidemiology/etiology
MH  - Disease Progression
MH  - Female
MH  - Glycated Hemoglobin/*analysis
MH  - Humans
MH  - Kidney Function Tests/methods/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Renal Insufficiency, Chronic/*blood/diagnosis/epidemiology/etiology
MH  - Risk Factors
MH  - Singapore/epidemiology
OTO - NOTNLM
OT  - chronic kidney disease
OT  - haemoglobin A1c trajectory
OT  - type 2 diabetes mellitus
EDAT- 2018/12/20 06:00
MHDA- 2020/02/28 06:00
CRDT- 2018/12/20 06:00
PHST- 2018/11/12 00:00 [accepted]
PHST- 2018/12/20 06:00 [pubmed]
PHST- 2020/02/28 06:00 [medline]
PHST- 2018/12/20 06:00 [entrez]
AID - 10.1111/nep.13533 [doi]
PST - ppublish
SO  - Nephrology (Carlton). 2019 Oct;24(10):1026-1032. doi: 10.1111/nep.13533. Epub 
      2019 May 2.