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Diabetes Metab J : Diabetes & Metabolism Journal



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Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus
Hua-Xing Huang, Liang-Lan Shen, Hai-Yan Huang, Li-Hua Zhao, Feng Xu, Dong-Mei Zhang, Xiu-Lin Zhang, Tong Chen, Xue-Qin Wang, Yan Xie, Jian-Bin Su
Diabetes Metab J. 2021;45(6):868-879.   Published online March 23, 2021
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Type 2 diabetes mellitus (T2DM) is characterized by elevated fasting glucagon and impaired suppression of postprandial glucagon secretion, which may participate in diabetic complications. Therefore, we investigated the associations of plasma glucagon with estimated glomerular filtration rate (eGFR), albuminuria and diabetic kidney disease (DKD) in T2DM patients.
Fasting glucagon and postchallenge glucagon (assessed by area under the glucagon curve [AUCgla]) levels were determined during oral glucose tolerance tests. Patients with an eGFR <60 mL/min/1.73 m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g who presented with diabetic retinopathy were identified as having DKD.
Of the 2,436 recruited patients, fasting glucagon was correlated with eGFR and UACR (r=–0.112 and r=0.157, respectively; P<0.001), and AUCgla was also correlated with eGFR and UACR (r=–0.267 and r=0.234, respectively; P<0.001). Moreover, 31.7% (n=771) presented with DKD; the prevalence of DKD was 27.3%, 27.6%, 32.5%, and 39.2% in the first (Q1), second (Q2), third (Q3), and fourth quartile (Q4) of fasting glucagon, respectively; and the corresponding prevalence for AUCgla was 25.9%, 22.7%, 33.7%, and 44.4%, respectively. Furthermore, after adjusting for other clinical covariates, the adjusted odds ratios (ORs; 95% confidence intervals) for DKD in Q2, Q3, and Q4 versus Q1 of fasting glucagon were 0.946 (0.697 to 1.284), 1.209 (0.895 to 1.634), and 1.521 (1.129 to 2.049), respectively; the corresponding ORs of AUCgla were 0.825 (0.611 to 1.114), 1.323 (0.989 to 1.769), and 2.066 (1.546 to 2.760), respectively. Additionally, when we restricted our analysis in patients with glycosylated hemoglobin <7.0% (n=471), we found fasting glucagon and AUCgla were still independently associated with DKD.
Both increased fasting and postchallenge glucagon levels were independently associated with DKD in T2DM patients.


Citations to this article as recorded by  
  • Random survival forest for predicting the combined effects of multiple physiological risk factors on all-cause mortality
    Bu Zhao, Vy Kim Nguyen, Ming Xu, Justin A. Colacino, Olivier Jolliet
    Scientific Reports.2024;[Epub]     CrossRef
  • Glucagon in type 2 diabetes: Friend or foe?
    Irene Caruso, Nicola Marrano, Giuseppina Biondi, Valentina Annamaria Genchi, Rossella D'Oria, Gian Pio Sorice, Sebastio Perrini, Angelo Cignarelli, Annalisa Natalicchio, Luigi Laviola, Francesco Giorgino
    Diabetes/Metabolism Research and Reviews.2023;[Epub]     CrossRef

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