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KIDNEY INT：糖尿病血液透析患者糖化血红蛋白水平分布及其与死亡率的关系！

2017-04-09 xing.T MedSci原创

糖尿病血液透析HbA1c死亡率
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在日本与西方国家报道的糖尿病血液透析患者HbA1c水平差异很大。因此，该研究结果强调了针对种族和国家的血糖控制指南的重要性。

糖尿病血液透析患者糖化血红蛋白（HbA1c）水平低于6.5%和超过8%就会面临更高的死亡风险。近日，肾脏病领域权威杂志kidney international上发表了一篇研究文章，研究人员旨在明确HbA1c与死亡率之间的相关性。

在2-5期日本透析预后与实践模式研究（JDOPPS研究）招募时研究人员对2300名维持性血液透析的糖尿病患者的HbA1c水平进行检测；在对基线年龄、性别、透析时间、12种一般合并症、血红蛋白、白蛋白、肌酐水平、胰岛素使用进行调整后，研究人员使用Cox回归分析这种相关性，并且对JDOPPS研究的阶段进行分层。

总体而言，54%的患者HbA1c水平低于6，其中，14%的患者HbA1c水平低于5。HbA1c水平较高的患者，胰岛素或口服糖尿病药物使用较少。死亡率对HbA1c水平的依赖性为U型。在调整后的模型中，将死亡率最低的组（HbA1c 6.0-7.0）作为参考，HbA1c分组＜5、5.0-6.0、7.0-8.0和＞8.0的风险比分别为1.56（95%可信区间为1.05-2.33）、1.26（0.92-1.71）、1.23（0.79-1.89）和2.10（1.32-3.33）。在JDOPPS研究5期，HbA1c水平并与自我报告的低血糖发作并不相关。

在日本与西方国家报道的糖尿病血液透析患者HbA1c水平差异很大。因此，该研究结果强调了针对种族和国家的血糖控制指南的重要性。

原始出处：

Junichi Hoshino,et al. Unique hemoglobin A1c level distribution and its relationship with mortality in diabetic hemodialysis patients.kidney-international.2017. http://www.kidney-international.org/article/S0085-2538(17)30110-2/fulltext

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    2017-04-30 1e145228m78(暂无匿称)

    学习了，谢谢作者分享!

    0

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    2017-04-11 habb

    #血液透析#

    0

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    2017-04-11 ewsr6

    #透析患者#

    0

  4. 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encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Tue Apr 11 08:38:00 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186586, encodeId=0d15186586c3, content=学习了不少事情！, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Tue Apr 11 07:44:06 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186353, encodeId=080a186353dc, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Mon Apr 10 08:19:41 CST 2017, time=2017-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186267, encodeId=a8e218626e3f, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJicFGXtYqfjGiaibNdjOiaRgkexnXiciaDeXaLiaKicovcicDugdYwRPSnQj3FlfXBwVLB5ANB9PGFyB0kraQ/0, createdBy=35b01663265, createdName=1ddf3e1dm99(暂无匿称), createdTime=Sun Apr 09 21:29:50 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186257, encodeId=a08d18625ea2, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Apr 09 21:26:16 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186226, encodeId=5ea718622659, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Apr 09 17:54:33 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186225, encodeId=0a67186225b9, content=死亡率对HbA1c水平的依赖性为U型。, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Apr 09 17:52:25 CST 2017, time=2017-04-09, status=1, ipAttribution=)]
    2017-04-11 gwc389

    #kidney#

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Apr 09 21:26:16 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186226, encodeId=5ea718622659, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Apr 09 17:54:33 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186225, encodeId=0a67186225b9, content=死亡率对HbA1c水平的依赖性为U型。, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Apr 09 17:52:25 CST 2017, time=2017-04-09, status=1, ipAttribution=)]
    2017-04-11 圣艮山

    学习了不少事情！

    0

  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Apr 09 21:26:16 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186226, encodeId=5ea718622659, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Apr 09 17:54:33 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186225, encodeId=0a67186225b9, content=死亡率对HbA1c水平的依赖性为U型。, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Apr 09 17:52:25 CST 2017, time=2017-04-09, status=1, ipAttribution=)]
    2017-04-10 tofsw

    学习了谢谢分享

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Mon Apr 10 08:19:41 CST 2017, time=2017-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186267, encodeId=a8e218626e3f, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJicFGXtYqfjGiaibNdjOiaRgkexnXiciaDeXaLiaKicovcicDugdYwRPSnQj3FlfXBwVLB5ANB9PGFyB0kraQ/0, createdBy=35b01663265, createdName=1ddf3e1dm99(暂无匿称), createdTime=Sun Apr 09 21:29:50 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186257, encodeId=a08d18625ea2, content=不错的方式，努力学习，刻苦专研，不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Apr 09 21:26:16 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186226, encodeId=5ea718622659, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Apr 09 17:54:33 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186225, encodeId=0a67186225b9, content=死亡率对HbA1c水平的依赖性为U型。, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Apr 09 17:52:25 CST 2017, time=2017-04-09, status=1, ipAttribution=)]
    2017-04-09 1ddf3e1dm99(暂无匿称)

    学习了，谢谢

    0

  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Apr 09 21:26:16 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186226, encodeId=5ea718622659, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Apr 09 17:54:33 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186225, encodeId=0a67186225b9, content=死亡率对HbA1c水平的依赖性为U型。, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Apr 09 17:52:25 CST 2017, time=2017-04-09, status=1, ipAttribution=)]
    2017-04-09 虈亣靌

    不错的方式，努力学习，刻苦专研，不断总结出来新经验。

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Apr 09 21:26:16 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186226, encodeId=5ea718622659, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Sun Apr 09 17:54:33 CST 2017, time=2017-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186225, encodeId=0a67186225b9, content=死亡率对HbA1c水平的依赖性为U型。, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Apr 09 17:52:25 CST 2017, time=2017-04-09, status=1, ipAttribution=)]
    2017-04-09 thlabcde

    好东西学习了！

    0

  10. 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    2017-04-09 1e1a50a1m36(暂无匿称)

    死亡率对HbA1c水平的依赖性为U型。

    0

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