Diabetic Med:性别调控亚洲2型糖尿病患者成纤维细胞生长因子21与终末期肾病的关联性

2018-10-25 MedSci MedSci原创

近日,国际杂志 《Diabetic Med》上在线发表一项关于性别调节亚洲2型糖尿病患者成纤维细胞生长因子21与终末期肾病的关联,该研究是一项为期6.3年的前瞻性队列研究。研究血浆成纤维细胞生长因子21是否能独立预测亚洲2型糖尿病患者终末期肾病的风险。 在这项前瞻性队列研究中,研究人员在新加坡的一家地区医院对1700名患有2型糖尿病的亚洲人进行了平均6.3年随访。通过与国家肾脏登记处的数据来

近日,国际杂志 《Diabetic Med》上在线发表一项关于性别调节亚洲2糖尿病患者成纤维细胞生长因子21与终末期肾病的关联,该研究是一项为期6.3年的前瞻性队列研究。研究血浆成纤维细胞生长因子21是否能独立预测亚洲2糖尿病患者终末期肾病的风险。

在这项前瞻性队列研究中,研究人员在新加坡的一家地区医院对1700名患有2糖尿病的亚洲人进行了平均6.3年随访。通过与国家肾脏登记处的数据来鉴定事件性终末期肾病。使用生存分析研究基线成纤维细胞生长因子21水平与进展至终末期肾病的风险之间的关联。

研究结果显示,参与者年龄为60±10岁,平均糖尿病病程为12年。其估计GFR73±28ml/min/1.73m262%的参与者蛋白尿在基线水平。研究共鉴定了179例终末期肾病病例。血浆成纤维细胞生长因子21与性别相关,与终末期肾病相关(P 相互作用 = 0.003)。在校正传统风险因素(包括估计的GFR和白蛋白尿)后,成纤维细胞生长因子21(自然对数转换)的A1- sd增量与1.3295CI 1.05-1.66P=0.02)倍女性终末期肾病的危害增加相关。将死亡视为竞争风险并未实质性地改变结局[分配风险比1.3595CI 1.11-1.66P = 0.003]。在校正基线估计的GFR和白蛋白尿后,成纤维细胞生长因子21不能预测男性的终末期肾病风险[风险比1.0795CI 0.89-1.28P = 0.49]

研究表明,血浆成纤维细胞生长因子21水平独立预测女性2型糖尿病进展为终末期肾病的风险。FGF21,性别和肾脏进展之间的病理生理学关系值得进一步研究。

原始出处:

J.J. LiuS. LiuR. W. Met al. Sex modulates the association of fibroblast growth factor 21 with endstage renal disease in Asian people with Type 2 diabetes: a 6.3year prospective cohort study

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  5. 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  6. 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  7. 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近十多年来,无论是血液透析还是腹膜透析均在自身技术上有了突飞猛进的发展。随着研究的深入,越来越多的观察发现两种透析模式在是不同类型的终末期肾功能衰竭(ESRD)患者中疗效相差甚远。

Circ-Cardiovasc Inte:经皮冠状动脉介入治疗的终末期肾病患者抗凝治疗!

由此可见,在接受PCI的终末期肾病患者中,比伐卢定和UFH的频率相似,尽管使用方式在入选后有所变化用。接受PCI的终末期肾病患者使用比伐卢定的住院结局调整风险较低;然而,鉴于这种分析的观察性质,需要进行随机试验予以验证。

Arthritis Rheumatol:1995年至2014年狼疮性肾炎导致终末期肾病的死亡趋势

1995年至2014年间,白人、非洲裔美国人和西班牙裔患者的全因死亡率大幅下降,因心血管疾病和感染导致的死亡风险降低。

NEJM:尿毒症霜-病例报道

尿毒症霜与严重的氮质血症有关,并且是由汗液蒸发后皮肤上尿素结晶所致。在血液透析广泛可用的地区,这种症状十分罕见。

Diabetes Care:年轻1型糖尿病患者终末期肾病累积发病率降低

由此可见,在瑞典1型糖尿病患者人群中发生ESRD的风险仍然很低,而且似乎也随着时间的推移而有所降低。