Diabetes Care:糖尿病与估计的肾小球滤过率变化轨迹!

2018-06-03 xing.T MedSci原创

由此可见,糖尿病是肾功能下降的重要危险因素。那些患有糖尿病的个体肾功能下降的速度几乎是没有糖尿病个体的两倍。在诊断为糖尿病的人群中,在可改变的危险因素,包括高血压和血糖控制的个体中,出现了更加陡峭的下降,提示其仍是肾脏疾病预防中的靶点。

在一般人群中患有和不患有糖尿病的个体长期肾脏疾病的发展轨迹在很大程度上是没有特征的。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员将社区中的15517名社区动脉粥样硬化风险(ARIC)研究的参与者根据基线糖尿病状态(1987-1989;无糖尿病、未诊断的糖尿病和诊断的糖尿病)进行分类。在随访26年期间的4次访视中,研究人员使用随机截距和斜率的线性混合模型以量化估计的肾小球滤过率(eGFR)变化轨迹。

无糖尿病的受试者在整个研究期间调整的平均eGFR下降为1.4 mL/min/1.73m2/年(95%可信区间(CI)为1.5-1.4);未确诊糖尿病的受试者为1.8 mL/min/1.73m2/年(95%CI为2-1.7)(差异 vs. 无糖尿病,P<0.001);诊断糖尿病的受试者为2.5mL/min/1.73m2/年(95%CI为2.6-2.4)(差异 vs. 无糖尿病,P<0.001)。在被诊断为糖尿病的参与者中,eGFR下降的危险因素包括非洲裔美国人、APO1高危基因型、收缩压超过140mmHg、使用胰岛素和更高的HbA1c。

由此可见,糖尿病是肾功能下降的重要危险因素。那些患有糖尿病的个体肾功能下降的速度几乎是没有糖尿病个体的两倍。在诊断为糖尿病的人群中,在可改变的危险因素,包括高血压和血糖控制的个体中,出现了更加陡峭的下降,提示其仍是肾脏疾病预防中的靶点。

原始出处:

Bethany Warren,et al. Diabetes and Trajectories of Estimated Glomerular Filtration Rate: A Prospective Cohort Analysis of the Atherosclerosis Risk in Communities Study.Diabetes Care.2018. https://doi.org/10.2337/dc18-0277

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content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77891325708, createdName=13915d817bm, createdTime=Sun Jun 03 16:25:27 CST 2018, time=2018-06-03, status=1, ipAttribution=)]
    2018-06-06 惠映实验室

    学习了.谢谢分享.

    0

  7. 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content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77891325708, createdName=13915d817bm, createdTime=Sun Jun 03 16:25:27 CST 2018, time=2018-06-03, status=1, ipAttribution=)]
  8. 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encodeId=ebe03214e44f, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Jun 04 19:39:39 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321184, encodeId=b9a5321184d9, content=糖尿病肾损伤应重视., beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sun Jun 03 17:14:16 CST 2018, time=2018-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321177, encodeId=90923211e7c5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77891325708, createdName=13915d817bm, createdTime=Sun Jun 03 16:25:27 CST 2018, time=2018-06-03, status=1, ipAttribution=)]
    2018-06-04 惠映实验室

    学习了.谢谢分享.

    0

  9. 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content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77891325708, createdName=13915d817bm, createdTime=Sun Jun 03 16:25:27 CST 2018, time=2018-06-03, status=1, ipAttribution=)]
    2018-06-03 1e0f8808m18(暂无匿称)

    糖尿病肾损伤应重视.

    0

  10. 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content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=77891325708, createdName=13915d817bm, createdTime=Sun Jun 03 16:25:27 CST 2018, time=2018-06-03, status=1, ipAttribution=)]
    2018-06-03 13915d817bm

    学习了

    0

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人β-防御素(hBD)-1是牙龈抵抗持续不断细菌侵害的一个重要防御,并且葡萄糖水平参与调节其最佳表达状态。这篇研究的目的是为了调查龈沟液(GCF)中hBD-1的表达水平,并比较它在II型糖尿病伴随牙周炎与否的患者和健康个体之间的水平差异。

Diabetologia:糖尿病患者的代谢组学

近日,国际杂志 《Diabetologia》上在线发表一项关于糖尿病患者的代谢组学的研究。 代谢组学分析可以提供揭示与糖尿病病理生理学相关的代谢途径并改善糖尿病风险预测的潜力。研究人员前瞻性地分析了从基线(1987-1989)和事件性糖尿病到2015年12月31日的2939例动脉粥样硬化风险社区(ARIC)研究参与者和无糖尿病患者的代谢组学数据,使用非靶向方法测定他们血清标本中的已知代谢物。

Eur J Gastroenterol Hepatol:患有非酒精性肝病的糖尿病患者,其心血管疾病的风险增加

这是独立于DM的影响,最先研究NAFLD与CVD之间关系的荟萃分析。研究结果表明,NAFLD增加了具有类似DM的人群的CVD的风险。诊断为NAFLD的糖尿病患者可能受益于更早期的心血管风险评估,从而降低心血管疾病的发病率和死亡率。

Diabetologia:1型糖尿病遗传风险评分可以区分糖尿病的单基因自身免疫性疾病与糖尿病多基因自身免疫的早发性聚类

近日,国际杂志 《Diabetologia》上在线发表一项关于1型糖尿病遗传风险评分可以区分糖尿病的单基因自身免疫性疾病与糖尿病多基因自身免疫的早发性聚类的研究。 研究发现子宫内暴露于妊娠糖尿病的9至16岁的女孩的患者端粒长度减少。缩短的端粒长度是细胞损伤的标志,并且与氧化应激,慢性炎症和代谢疾病有关。研究人员假设妊娠期糖尿病(GDM)患有心血管和代谢疾病风险增加的女性的后代可能会表现出较短