ArticleBMJ open diabetes research & care2025
Influence of metabolism-related comorbidities and insulin resistance on new onset of chronic kidney disease in a health check-up population: a two-stage retrospective cohort study.
Article in BMJ open diabetes research & care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Multi-trajectories of serum uric acid/high density lipoprotein cholesterol ratio and fasting plasma glucose in chronic kidney disease.Annals of medicine · 2026Article
- Prevalence and Factors Associated With Poor Glycaemic Control in Type 2 Diabetes Mellitus Patients: A Single-Centre, Hospital-Based Cross-Sectional Study in Jhenaidah District, Bangladesh.Endocrinology, diabetes & metabolism · 2026Article
- Non-insulin-dependent insulin resistance surrogate indexes for predicting chronic kidney disease in diabetic individuals: a prospective cohort study.BMC endocrine disorders · 2026Article
- The Neuro-Cardio-Renal Stress Index (NCR-SI): A Pragmatic Composite Framework for Characterizing Multisystem Burden in Multimorbid Patients.Diagnostics (Basel, Switzerland) · 2026Article
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8 authors.
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Abstract
introductionLimited research has focused on the prospective influence of insulin resistance (IR) on new-onset chronic kidney disease (CKD) in healthy screening populations. Therefore, we aimed to investigate how IR, assessed via the estimated glucose disposal rate (eGDR), and metabolism-related comorbidities influence new-onset CKD. RESEARCH DESIGN AND
methodsThis two-stage retrospective cohort study (cross-sectional and longitudinal analyses) used data from health check-up participants at the Chinese People's Liberation Army General Hospital (2009-2021). The cross-sectional analysis included 83 346 participants with or without CKD; the longitudinal analyses included 13 738 participants without prior CKD who visited the hospital at least two times. The cross-sectional phase of this study analyzed the relationship between IR and CKD; the longitudinal phase analyzed the relationship between IR and new-onset CKD. The mediating role of metabolism-related comorbidities was also explored.
resultsIn the cross-sectional analysis, 6.77% (n=5643) of patients had prior CKD. The eGDR was significantly higher in the non-CKD group than in the CKD group (9.16±2.11 vs 7.19±2.32, p<0.001). Higher eGDR was associated with lower CKD prevalence (OR: 0.91, 95% CI: 0.89 to 0.93, P for trend<0.001). In the cohort analysis, the average time to trigger endpoint events was 2.95±2.02 years, with 403 (2.93%) new-onset CKD cases reported. A linear correlation was observed between eGDR and new-onset CKD (p<0.001), with higher eGDR linked to reduced CKD risk (HR: 0.88, 95% CI: 0.82 to 0.96, P for trend=0.002). Mediation analysis revealed significant indirect effects of diabetes mellitus (17.1%), systolic blood pressure (22.0%), glycated hemoglobin (11.1%), and brachial-ankle pulse wave velocity (9.7%) (all p<0.05).
conclusionsIR is independently linked to new-onset CKD, with blood glucose, blood pressure, and arterial stiffness mediating this relationship. These findings underscore the importance of managing IR and metabolic comorbidities to prevent CKD onset in at-risk populations.
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