Abstract

Although glomerular hyperfiltration (GHF) is a major risk of diabetic nephropathy and it is important to prevent GHF in subjects with prediabetes, it is not known which factors are associated with the risk of GHF. We prospectively examined the relationship of alcohol consumption and smoking habits to the risk of GHF in subjects with impaired fasting glucose (IFG). Study population was 2811 middle-aged Japanese men who had IFG, no proteinuria, no GHF, and no low estimated glomerular filtration rate (eGFR) at baseline, and who did not have low eGFR before the onset of GHF during the follow-up period. GHF was defined as eGFR ≥117 mL/min/1.73 m2, which was the upper 2.5th percentile value of eGFR in the all study population of our cohort. Low eGFR was defined as eGFR <60 mL/min/1.73 m2. Based on daily alcohol consumption, subjects were classified as follows: non-drinkers, 0.1-23.0, 23.1-46.0, and ≥46.1 g ethanol/day. As for smoking habits, subjects were divided into non-smokers, past smokers, and current smokers. During the 6-year follow-up period, 103 men developed GHF. After adjusted for BMI, fasting plasma glucose, systolic blood pressure, use of anti-hypertensive medications, and regular physical exercise, both daily alcohol consumption and smoking habits were independently associated with the risk of the incident GHF. Multiple-adjusted HRs of incident GHF for those who drank 0.1-23.0, 23.1-46.0, and ≥46.1 g ethanol/day were 0.94 (95% CI, 0.46-1.95), 1.34 (0.66-2.70), and 2.48 (1.19-5.15), respectively, compared with non-drinkers. Multiple-adjusted HRs of those for past smokers and current smokers were 0.86 (0.42-1.75), and 1.77 (1.00-3.14), respectively, compared with non-smokers. In conclusion, high daily alcohol consumption and current smoking increased the risk of GHF in subjects with IFG. Disclosure M. Shibata: None. T. Hayashi: None. K. K. Sato: None. S. Uehara: None. N. Nishida: None. K. Okamura: None. I. Shibata: None. H. Koh: None. K. Oue: None. M. Morimoto: None.

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