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More than 1 in 7 US adults-about 35.5 million people have chronic kidney disease (CKD) , which increases the risk of many adverse events. α1-acid glycoprotein (AGP), has been associated with energy metabolism, which mitigates acute kidney injury (AKI) and its progression to CKD, and protect against renal fibrosis in animal studies. However, studies that used large population-based database research are limited. Therefore, this study aimed to investigate whether CKD prevalence is associated with serum α1-AGP levels in female adults in the US.
This nationally representative cross-sectional study used data on female adults in the US aged 20–49 years from the National Health and Nutrition Examination Survey 2015–2018 cycles. A total of 2,137 individuals were included in the study after excluding individuals without α1-AGP and urine albumin & creatinine data. Multivariate logistic regression models were used to evaluate the association between α1-AGP and CKD. Moreover, we performed stratified and interaction analyses to see if the relationship was stable in different subgroups.
Among the 2,137 participants (mean age of 34.6 years), the mean eGFR was 111.7 (SD=17.9) mL/min/1.73m2, and CKD was diagnosed in 8.8% of them (n=188). A negative relationship was observed between the occurrence of CKD and serum α1-AGP level. In the fully adjusted model, α1-AGP was negatively associated with CKD (CKD all, OR = 0.4, 95% CI 0.17-0.93, p = 0.034; CKD stage≥1, OR = 0.49, 95% CI 0.21-1.19, p = 0.115; CKD stage≥3, OR = 0.07, 95% CI 0-1.27, p = 0.072; ACR ≥ 30 mg/g, OR = 0.42, 95% CI 0.18-1, p = 0.051). And this trend was more obvious in the group with higher serum α1-AGP levels (divided into four parts: Q1-Q4). Some differences in the association between α1-AGP and CKD were found in stratified analyses, however, these differences lacked statistical significance.
Serum α1-AGP was negatively associated with the prevalence of CKD. However, the study participants were US female ages 20 to 49, further research is required to validate these findings in diverse populations.