JCEM:舒张压和ACR是2型糖尿病患者动脉硬化可改变的危险因素

2022-05-24 MedSci原创 MedSci原创

在没有明显的心血管疾病和慢性肾功能不全的情况下,2型糖尿病患者心踝血管指数通常为病理状态。DBP和ACR是2型糖尿病患者血管僵硬可改变的危险因素,因此需要对其进行进一步评估。

2型糖尿病是导致不良血管事件、失明、周围神经病变和终末期肾病的主要原因。为了在心血管事件和慢性肾功能不全发病之前及早评估2型糖尿病过程中慢性肾脏疾病-矿物质骨疾病生物标志物与血管僵硬(心踝血管指数)之间的关联。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,研究人员评估了174名糖尿病病程10年以上且估计的肾小球滤过率无降低(eGFR≥60ml/min/1.73m2)或大血管并发症的2型糖尿病患者(中位年龄为56岁;男性/女性=100/74)。

34名年龄匹配的健康受试者(男性/女性:13/21;平均年龄为53.5[50.0-57.7]岁;eGFR为107.5[97.0-119.7]ml/ml/min/1.73m2)作为心踝血管指数(病理状态≥8)和新的慢性肾脏疾病-矿物质骨疾病生物标志物的局部参考对照。

受试者白蛋白-肌酐比(ACR)平均值为8.5mg/g[5.6-17.2],其中12.6%的患者表现出病理状态,表明存在早期糖尿病肾病(DN)。血清甲状旁腺激素、成纤维细胞生长因子23和硬化蛋白水平较高,而1,25-二羟基维生素D3和Klotho水平低于对照组。只有54%的受试者心踝血管指数正常(<8),并且与年龄(p<0.001)、Hb1A1c水平(p=0.036)、收缩压(p=0.021)和舒张压(DBP)(p=0.001)呈正相关,而与25羟基维生素D3呈负相关(p=0.046)。在多变量分析中,年龄、DBP、ACR和s-Klotho是心踝血管指数的独立阳性预测因子。

由此可见,在没有明显的心血管疾病和慢性肾功能不全的情况下,2型糖尿病患者心踝血管指数通常为病理状态。DBP和ACR是2型糖尿病患者血管僵硬可改变的危险因素,因此需要对其进行进一步评估。

原始出处:

Gateano Leto,et al.Diastolic Pressure And Acr Are Modifiable Risk Factors Of Arterial Stiffness In T2DM Without Cardiovascular Disease.JCEM.2022.https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgac291/6590071?redirectedFrom=fulltext

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    2022-11-11 achengzhao
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    2023-01-06 smallant2015
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    2022-05-25 10518094zz
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