{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:16:49Z","timestamp":1789168609775,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003173","name":"Crafoordska Stiftelsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003173","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019649","name":"Southwest Skanes Diabetes Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019649","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2022\u201000973"],"award-info":[{"award-number":["2022\u201000973"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003252","name":"Lunds Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011077","name":"Sk\u00e5nes universitetssjukhus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011077","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017018","name":"Wallenberg Centre for Molecular and Translational Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006075","name":"Greta och Johan Kocks stiftelser","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009761","name":"Hulda och E Conrad Mossfelts Stiftelse f\u00f6r Vetenskaplig Forskning Inom Hj\u00e4rt- och K\u00e4rlsjukdomarnas Omr\u00e5de","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009761","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009748","name":"Ernhold Lundstr\u00f6ms stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009748","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003173","name":"Crafoordska Stiftelsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003173","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2026,10]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Discordance between cystatin C\u2010 and creatinine\u2010based estimated glomerular filtration rate (eGFR) has been linked to adverse outcomes. A low eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio, conceptualized as selective glomerular hypofiltration syndrome (SGHS), has been hypothesized to reflect early metabolic kidney vulnerability, although non\u2010glomerular filtration rate determinants may also contribute. We investigated associations of dysglycemia and insulin resistance with the eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio in a general population.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In 28,078 participants aged 50\u201364 years from the Swedish CArdioPulmonary bioImage Study, we assessed glycemic status (normoglycemia, prediabetes, and diabetes), hemoglobin A1c (HbA1c), fasting glucose, and insulin resistance (homeostatic model assessment of insulin resistance [HOMA\u2010IR]). Outcomes were the continuous eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio and SGHS defined as eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio <0.7. Multivariable linear and logistic regression adjusted for demographic, metabolic, cardiovascular, and kidney covariates; sensitivity analyses used alternative eGFR equations.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Mean eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio declined across glycemic categories (normoglycemia 0.95, prediabetes 0.90, diabetes 0.85;\n p<\/jats:italic>\n \u00a0<\u00a00.001). SGHS prevalence increased stepwise (6.5%, 10.7%, and 19.5%, respectively). In fully adjusted models, higher HbA1c (per 10\u00a0mmol\/mol) and fasting glucose (per 1\u00a0mmol\/L) were inversely associated with the eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio (\n \u03b2<\/jats:italic>\n \u22120.015 and \u22120.008, respectively; both\n p<\/jats:italic>\n \u00a0<\u00a00.001) and positively associated with SGHS (odds ratio [OR] 1.27 and 1.12; both\n p<\/jats:italic>\n \u00a0<\u00a00.001). Higher HOMA\u2010IR was independently associated with SGHS, with the strongest associations observed in normoglycemia (OR 1.27, 95% confidence interval [CI] 1.12\u20131.45) and prediabetes (OR 1.41, 95% CI 1.12\u20131.76).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Dysglycemia and insulin resistance were associated with a lower eGFR\n cys<\/jats:sub>\n \/eGFR\n cr<\/jats:sub>\n \u2010ratio and higher SGHS prevalence. These findings may reflect kidney vulnerability, altered biomarker metabolism, or both.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/joim.70148","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T09:48:11Z","timestamp":1786528091000},"page":"499-512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Selective glomerular hypofiltration is associated with glucometabolic disturbances in the general population"],"prefix":"10.1111","volume":"300","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8399-8854","authenticated-orcid":false,"given":"Christopher","family":"Nilsson","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"},{"name":"Department of Nephrology Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4020-1467","authenticated-orcid":false,"given":"Agne","family":"Laucyte\u2010Cibulskiene","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"},{"name":"Department of Nephrology Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9506-0158","authenticated-orcid":false,"given":"Amra","family":"Jujic","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0043-1727","authenticated-orcid":false,"given":"Marcus A.","family":"Ohlsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Guron","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine\/Nephrology Institute of Medicine The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7545-5585","authenticated-orcid":false,"given":"Maria K.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Renal Medicine Uppsala University Uppsala Sweden"},{"name":"Uppsala Clinical Research Center Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8183-3984","authenticated-orcid":false,"given":"Maria","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Health and Caring Sciences Link\u00f6ping University Link\u00f6ping Sweden"},{"name":"Department of Clinical Nephrology Region \u00d6sterg\u00f6tland Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-0707","authenticated-orcid":false,"given":"P. Andreas","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6933-4637","authenticated-orcid":false,"given":"Johan","family":"\u00c4rnl\u00f6v","sequence":"additional","affiliation":[{"name":"Division of Family Medicine and Primary Care Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden"},{"name":"School of Health and Social Studies Dalarna University Falun Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0125-3662","authenticated-orcid":false,"given":"Anders","family":"Grubb","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Sk\u00e5ne University Hospital Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3161-0402","authenticated-orcid":false,"given":"Anders","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Clinical Chemistry Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1710-5936","authenticated-orcid":false,"given":"Martin","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"},{"name":"Department of Cardiology Lund University Malm\u00f6 Sweden"},{"name":"Wallenberg Centre for Molecular Medicine Lund University Lund Sweden"},{"name":"Hypertension in Africa Research Team (HART) North\u2010West University Potchefstroom South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7328-8418","authenticated-orcid":false,"given":"Anders","family":"Christensson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University Malm\u00f6 Sweden"},{"name":"Department of Nephrology Sk\u00e5ne University Hospital Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9030813"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci23-0030"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jmcb\/mjab024"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2015.1025427"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.14278"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2023.04.002"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfad145"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13589"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.14939"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2364"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12384"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2013.220707"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1992.tb01732.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2102953"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1114248"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2013-0741"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2006.076042"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2020.1759139"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000217"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-025-06430-6"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-69623-w"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2024.02.014"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000371557"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010050479"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-75667-5"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2010.546879"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00517.x"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.110.223545"},{"issue":"9","key":"e_1_2_11_32_1","article-title":"The bidirectional link between diabetes and kidney disease: mechanisms and management","volume":"15","author":"Kumar M","year":"2023","journal-title":"Cureus."},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.2337\/dbi16-0056"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfad052"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2025.06.019"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.11.2022"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs290"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep45522"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0235"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneph.2023.1133352"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2023.100727"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac254"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265088"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.70148","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joim.70148","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.70148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:52:59Z","timestamp":1789167179000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joim.70148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/joim.70148"],"URL":"https:\/\/doi.org\/10.1111\/joim.70148","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"assertion":[{"value":"2026-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}