One-Hour Post load Plasma Glucose Levels Are Associated with Kidney Dysfunction

Background and objectives: A cutoff of 155 mg/dl for 1-hour postload plasma glucose (1hPG) during the oral glucose tolerance test (OGTT) is able to identify patients who are at high risk for type 2 diabetes and vascular atherosclerosis. We aimed to examine whether individuals with 1hPG >= 155 mg/dl are also at increased risk for chronic kidney disease (CKD). Design, setting, participants, & measurements: Atherosclerosis risk factors, OGTT, and estimated GFR by Chronic Kidney Disease Epidemiology Collaboration equation were analyzed in 1075 white individuals without diabetes. Results: The area under the receiver operating characteristic curve for 1hPG was the highest (0.700) compared with the areas under the receiver operating characteristic curve of 0, 30-minute, and 2-hour glucose concentrations. Individuals with 1hPG <155 mg/dl had a worse cardiometabolic risk profile, exhibiting significantly higher body mass index, BP, triglycerides, and fasting insulin levels and lower HDL, IGF-1 levels, and insulin sensitivity, than individuals with 1hPG <155 mg/dl. Estimated GFR was significantly lower in individuals with 1hPG >= 155 mg/dl. In a logistic regression model adjusted for age and gender, individuals with 1hPG >= 155 mg/dl showed an increased risk for CKD compared with individuals with 1hPG <155 mg/dl. When the logistic regression analysis was restricted to individuals who had normal glucose tolerance, those with 1hPG >= 155 mg/dl showed a higher risk for CKD compared with individuals with 1hPG <155 mg/dl. Conclusions: These data suggest that a cutoff point of 155 mg/dl for the 1hPG during OGTT may be helpful in the identification of individuals who are at increased risk for CKD. Clin J Am Soc Nephrol 5: 1922-1927, 2010. doi: 10.2215/CJN.03240410