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代谢综合征及其各组分对 2 型糖尿病患者肾功能的影响。

Effect of metabolic syndrome and of its individual components on renal function of patients with type 2 diabetes mellitus.

机构信息

Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.

出版信息

Braz J Med Biol Res. 2010 Jul;43(7):687-93. doi: 10.1590/s0100-879x2010007500054. Epub 2010 Jun 11.

Abstract

The objective of this study was to evaluate the effect of metabolic syndrome (MetS) and its individual components on the renal function of patients with type 2 diabetes mellitus (DM). A cross-sectional study was performed in 842 type 2 DM patients. A clinical and laboratory evaluation, including estimated glomerular filtration rate (eGFR) calculated by the modification of diet in renal disease formula, was performed. MetS was defined according to National Cholesterol Education Program - Adult Treatment Panel III criteria. Mean patient age was 57.9 +/- 10.1 years and 313 (37.2%) patients were males. MetS was detected in 662 (78.6%) patients. A progressive reduction in eGFR was observed as the number of individual MetS components increased (one: 98.2 +/- 30.8; two: 92.9 +/- 28.1; three: 84.0 +/- 25.1; four: 83.8 +/- 28.5, and five: 79.0 +/- 23.0; P < 0.001). MetS increased the risk for low eGFR (<60 mL x min(-1) x 1.73 (m2)(-1)) 2.82-fold (95%CI = 1.55-5.12, P < 0.001). Hypertension (OR = 2.2, 95%CI = 1.39-3.49, P = 0.001) and hypertriglyceridemia (OR = 1.62, 95%CI = 1.19-2.20, P = 0.002) were the individual components with the strongest associations with low eGFR. In conclusion, there is an association between MetS and the reduction of eGFR in patients with type 2 DM, with hypertension and hypertriglyceridemia being the most important contributors in this sample. Interventional studies should be conducted to determine if treatment of MetS can prevent renal failure in type 2 DM patients.

摘要

本研究旨在评估代谢综合征(MetS)及其各组分对 2 型糖尿病(DM)患者肾功能的影响。对 842 例 2 型 DM 患者进行了横断面研究。进行了临床和实验室评估,包括通过肾脏病饮食改良公式计算的估算肾小球滤过率(eGFR)。MetS 按照国家胆固醇教育计划-成人治疗小组 III 标准定义。患者平均年龄为 57.9 +/- 10.1 岁,313 例(37.2%)为男性。662 例(78.6%)患者检测到 MetS。随着单个 MetS 成分数量的增加,eGFR 呈逐渐下降趋势(一个:98.2 +/- 30.8;两个:92.9 +/- 28.1;三个:84.0 +/- 25.1;四个:83.8 +/- 28.5,五个:79.0 +/- 23.0;P < 0.001)。MetS 使 eGFR 降低(<60 mL x min(-1) x 1.73 (m2)(-1))的风险增加 2.82 倍(95%CI = 1.55-5.12,P < 0.001)。高血压(OR = 2.2,95%CI = 1.39-3.49,P = 0.001)和高三酰甘油血症(OR = 1.62,95%CI = 1.19-2.20,P = 0.002)是与 eGFR 降低相关性最强的单个成分。总之,在 2 型 DM 患者中,MetS 与 eGFR 降低之间存在关联,高血压和高三酰甘油血症是该样本中最重要的贡献因素。应进行干预性研究,以确定治疗 MetS 是否可以预防 2 型 DM 患者的肾衰竭。

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