中国成年2型糖尿病患者的肾脏疾病参数、代谢目标实现情况和动脉硬化风险

Abstract

Abstract Background To investigate the arterial stiffness (AS) risk within urinary albumin‐to‐creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) categories and the joint effect between kidney disease parameters and metabolic goal achievement on AS risk in adult people with type 2 diabetes (T2D). Methods A total of 27 439 Chinese participants with T2D from 10 National Metabolic Management Centers (MMC) were categorized into four albuminuria/decreased eGFR groups. The criteria for decreased eGFR and AS were eGFR the 75th percentile (1770.0 cm/s). Three metabolic goals were defined as glycated hemoglobin <7%, BP <130/80 mmHg, andlow‐density lipoprotein cholesterol <2.6 mmol/L. Results After full adjustment, odds ratios (ORs) for AS were highest for albuminuria and decreased eGFR (2.23 [1.98–2.52]) and were higher for albuminuria and normal eGFR (1.52 [1.39–1.67]) than for those with nonalbuminuria and decreased eGFR (1.17 [1.04–1.32]). Both UACR and eGFR in the subgroup or overall population independently correlated with AS risk. The achievement of ≥2 metabolic goals counteracted the association between albuminuria and AS risk (OR: 0.93; 95% CI: 0.80–1.07; p = .311). When the metabolic goals added up to ≥2 for patients with decreased eGFR, they showed significantly lower AS risk (OR: 0.65; 95% CI: 0.56–0.74; p < .001). Conclusions Both higher UACR and lower eGFR are determinants of AS risk, with UACR more strongly related to AS than eGFR in adults with T2D. The correlation between albuminuria/decreased eGFR and AS was modified by the achievement of multiple metabolic elements.

Keywords

• 2型糖尿病
• 尿白蛋白/肌酐比值(UACR)
• 估计肾小球滤过率(eGFR)
• 臂‐踝脉搏波传导速度(BaPWV)
• 心血管疾病
• 代谢目标