# Estimated Glomerular Filtration Rate and Incident Prediabetes Risk in Normoglycemic Adults With Parental Type 2 Diabetes

## TL;DR

Higher kidney function in healthy people with a family history of diabetes is linked to better metabolic health and lower risk of developing prediabetes.

## Contribution

This study identifies a novel association between baseline eGFR and incident prediabetes risk in normoglycemic individuals with parental type 2 diabetes.

## Key findings

- Higher baseline eGFR is associated with lower risk of developing prediabetes.
- eGFR correlates with metabolic syndrome components and glucoregulatory function.
- eGFR variations within the normal range reflect cardiometabolic risk and early dysglycemia.

## Abstract

We examined estimated glomerular filtration rate (eGFR) in relation to cardiometabolic and glucoregulatory factors and prediabetes risk in healthy subjects.

Participants were normoglycemic Black and White offspring of parents with type 2 diabetes followed for 5 years in the Pathobiology of Prediabetes in a Biracial Cohort study. Baseline assessments included clinical examination, oral glucose tolerance test, blood chemistries, insulin sensitivity (Si-clamp), insulin secretion, and eGFR (derived from the CKD-EPI equation). We analyzed baseline eGFR in relation to metabolic syndrome (MetS), glucoregulatory function, and prediabetes risk using linear regression and Cox proportional hazards models.

The participants (n = 296; 73% female; 138 Black, 158 White) were aged 45.5 ± 10.1 years; body mass index (BMI) was 30.5 ± 7.6 kg/m2, and eGFR was 103 ± 18.7 mL/min. Baseline eGFR increased with cumulative MetS components (ANOVA P = .0002) and correlated significantly with waist circumference (r = 0.39, P < .0001), high-density lipoprotein cholesterol (r = −0.38, P < .0001), Si-clamp (r = −0.22; P = .003), and insulin secretion (r = 0.22; P = .0003). Higher baseline eGFR predicted lower risk of incident prediabetes: hazard ratio 0.986 (95% confidence interval 0.975-0.997, P = .012), adjusted for age, sex, ethnicity, BMI, waist circumference, glucose, insulin sensitivity, insulin secretion, and albuminuria.

eGFR variations within the normal range signify cardiometabolic risk status, glucoregulatory function, and incident prediabetes risk among normoglycemic persons. Further studies are needed to determine the mechanisms linking kidney function and early dysglycemia.