U-shaped relationship between fasting blood glucose and urinary albumin-to-creatinine ratio in the general United States population

Front Endocrinol (Lausanne). 2024 Mar 15:15:1334949. doi: 10.3389/fendo.2024.1334949. eCollection 2024.

Abstract

Objective: The current controversy surrounding the association between fasting blood glucose (FBG) and albuminuria necessitates further investigation. Hence, the primary objective of this study was to examine the relationship between FBG and urinary albumin-to-creatinine ratio (UACR).

Methods: A cohort of complete data from National Health and Nutrition Examination Survey (NHANES) participants (1999-2020) was analyzed. Linear regression analyses and a generalized additive model explored the association between FBG and UACR. Furthermore, the stability of this relationship across different populations was assessed.

Results: The study involved a total of 20,264 participants who were identified as U.S. citizens. By employing linear regression analysis, a statistically significant relationship was observed between elevated FBG levels and an increase in UACR (P<0.0001). Additionally, using a generalized additive model analysis, a U-shaped correlation between FBG and UACR was identified. Further examination using threshold effect analysis indicated a turning point for FBG at 5.44 mmol/L. A noteworthy finding in multiple populations is the consistent U-shaped association between FBG and UACR, except for individuals with serum uric acid levels ≥420 μmol/L and those who refrain from alcohol consumption.

Conclusion: The general U.S. population has a U-shaped nonlinear relationship between FBG and UACR.

Keywords: NHANES; U-shaped relationship; albuminuria; fasting blood glucose; urinary albumin-to-creatinine ratio.

MeSH terms

  • Albumins
  • Blood Glucose*
  • Creatinine
  • Fasting
  • Humans
  • Nutrition Surveys
  • United States / epidemiology
  • Uric Acid*

Substances

  • Creatinine
  • Blood Glucose
  • Uric Acid
  • Albumins

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.