Diabetes Care:血糖异常者肾功能改变的新型生物标志物

2020-01-07 xing.T MedSci原创

由此可见,在常规测量的临床危险因素中添加多达16种生物标志物可以改善血糖异常患者eGFR年度变化的预测能力。

糖尿病是肾功能下降和衰竭的主要危险因素。生化标志物多重组合提供了确定新生物标志物的机会,该新型生物标志物比常规可用的临床标志物能更好地预测肾功能变化。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员测量了来自甘精胰岛素减少结局的干预(ORIGIN)试验中生物标志物亚组受试者血清中239种生化标志物的浓度。重复测量的混合效应模型用于计算7482名参与者的eGFR年度变化(以mL/min/1.73m2/年来衡量),并记录了基线和随访eGFR。在考虑基线HbA1c、基线eGFR和常规测量的临床危险因素后,研究人员使用正向选择的线性回归模型来确定eGFR年度变化的独立生物标志物决定因素,还估计了根据这些模型预测的eGFR每变化25%,复合肾结局(即肾脏替代疗法、肾死亡、肾衰竭、白蛋白尿进展、血清肌酐加倍)和死亡的发生率。

在6.2年的中位随访期间,eGFR的中位年变化为-0.18 mL/min/1.73m2/年。在考虑了心血管危险因素后,15种生物标志物可独立预测eGFR下降,其中12种在考虑了肾脏危险因素后,也可预测eGFR下降。估计的eGFR每下降0.1mL/min/1.73m2,则表明死亡率增加13%(95%CI为12-14%)。

由此可见,在常规测量的临床危险因素中添加多达16种生物标志物可以改善血糖异常患者eGFR年度变化的预测能力。

原始出处:

Hertzel C. Gerstein,et al.Novel Biomarkers for Change in Renal Function in People With Dysglycemia.Diabetes Care.2019.https://doi.org/10.2337/dc19-1604

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    2020-01-18 yese
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