Kidney int:2型糖尿病患者早期进行性肾衰竭标志物的新研究!

2018-02-09 MedSci MedSci原创

为了确定2型糖尿病患者早期进行性肾功能下降的决定因素,近期,一项发表在杂志Kidney int上的研究招募了第二次Joslin肾脏研究的1032名患者并检测了一系列标志物。在5-12年的随访过程中,通过连续测量血清肌酐估计的eGFR斜率定义了早期肾脏衰退。入选时,所有患者eGFR正常,58%有正常白蛋白尿,42%有白蛋白尿。 6%和18%的患者分别出现早期肾脏衰退。此外,此项研究还检测了临床特征的

为了确定2型糖尿病患者早期进行性肾功能下降的决定因素,近期,一项发表在杂志Kidney int上的研究招募了第二次Joslin肾脏研究的1032名患者并检测了一系列标志物。

在5-12年的随访过程中,通过连续测量血清肌酐估计的eGFR斜率定义了早期肾脏衰退。入选时,所有患者eGFR正常,58%有正常白蛋白尿,42%有白蛋白尿。 6%和18%的患者分别出现早期肾脏衰退。

此外,此项研究还检测了临床特征的基线值,循环标志物TNFR1、KIM-1和FGF23以及尿标志物:白蛋白、KIM-1、NGAL、MCP-1、EGF(全部归一化为尿肌酐)以及EGF与MCP-1的比值。

在单变量分析中,所有血浆和尿液标记物与早期肾脏衰退风险显着相关。当合并分析时,收缩压、TNFR1、KIM-1以及白蛋白与肌酸酐比率以及EGF / MCP-1比率仍然显着相关,后者具有最强的相关性。

将这些标记物整合到多标记物预后测试中,与单独的白蛋白与肌酐比率以及收缩压相比,其对早期肾脏衰退的风险预测的能力显着改善。然而,对蛋白尿患者阳性预测值仅为50%。

此项研究的血浆和尿液中的标志物表明,2型糖尿病患者的早期进行性肾功能衰减具有多个决定因素,并且具有强烈的肾小管损伤的证据。

原始出处:
Nowak N, Skupien J, et al.  Markers of early progressive renal decline in type 2 diabetes suggest different implications for etiological studies and prognostic tests development. Kidney Int. 2018 Feb 2. pii: S0085-2538(17)30892-X. doi: 10.1016/j.kint.2017.11.024.

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    2018-02-11 gwc389
  7. [GetPortalCommentsPageByObjectIdResponse(id=1976608, encodeId=ba8d19e6608d5, content=<a href='/topic/show?id=acd4943925f' target=_blank style='color:#2F92EE;'>#进行性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94392, encryptionId=acd4943925f, topicName=进行性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=869698, createdName=ligang4439, createdTime=Fri May 11 13:43:00 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1841189, encodeId=86d9184118940, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Tue Dec 11 09:43:00 CST 2018, time=2018-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299236, encodeId=ccb91299236a7, content=<a href='/topic/show?id=e7e882e50df' target=_blank style='color:#2F92EE;'>#肾衰竭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82750, encryptionId=e7e882e50df, topicName=肾衰竭)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad7f282, createdName=yang0210, createdTime=Sun Feb 11 09:43:00 CST 2018, time=2018-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383405, encodeId=ffc41383405cd, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Sun Feb 11 09:43:00 CST 2018, time=2018-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474430, encodeId=230a14e443016, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Sun Feb 11 09:43:00 CST 2018, time=2018-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603110, encodeId=3a36160311031, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Sun Feb 11 09:43:00 CST 2018, time=2018-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=286589, encodeId=bbd628658987, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Feb 09 21:23:08 CST 2018, time=2018-02-09, status=1, ipAttribution=)]
    2018-02-09 天地飞扬

    了解一下.谢谢分享!

    0

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