Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan.
Diabetes Care. 2011 Dec;34(12):2570-5. doi: 10.2337/dc11-1020. Epub 2011 Oct 4.
To investigate the association between aortic stiffness and incident albuminuria and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.
We investigated 461 Japanese type 2 diabetic patients, comprising 199 women and 262 men, with a mean age of 59 ± 11 years. Patients were divided into two groups according to the median value of carotid-femoral pulse wave velocity (cf-PWV), which was used to evaluate aortic stiffness. The end point was defined as the transition from normo- to microalbuminuria or micro- to macroalbuminuria. The Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% CI. The correlation between cf-PWV and rate of change in eGFR was also determined by linear regression analysis.
The baseline mean (± SD) cf-PWV was 9.6 ± 2.4 m/s. During a median follow-up period of 5.9 years (range 0.3-8.6), progression of albuminuria was observed in 85 patients. The 5-year cumulative incidence of the end point in patients with cf-PWV below and above the median was 8.5 and 19.4%, respectively (P = 0.002, log-rank test). cf-PWV was significantly associated with incident albuminuria (HR 1.23, 95% CI 1.13-1.33, P < 0.001) by multivariate Cox regression analysis. A significant association between cf-PWV and annual change in eGFR was also suggested by multiple linear regression analysis (standardized estimate -0.095, P = 0.031).
Aortic stiffness is associated with incident albuminuria and the rate of decline in glomerular filtration rate in type 2 diabetic patients.
探讨 2 型糖尿病患者主动脉僵硬与白蛋白尿事件及估算肾小球滤过率（eGFR）下降的关系。
我们调查了 461 名日本 2 型糖尿病患者，包括 199 名女性和 262 名男性，平均年龄为 59±11 岁。根据颈动脉-股动脉脉搏波速度（cf-PWV）的中位数将患者分为两组，cf-PWV 用于评估主动脉僵硬。终点定义为从正常白蛋白尿转变为微量白蛋白尿或从微量白蛋白尿转变为大量白蛋白尿。使用 Cox 比例风险模型计算危险比（HR）和 95%CI。还通过线性回归分析确定 cf-PWV 与 eGFR 变化率之间的相关性。
基线平均（±SD）cf-PWV 为 9.6±2.4m/s。在中位随访 5.9 年（范围 0.3-8.6 年）期间，85 例患者出现白蛋白尿进展。cf-PWV 低于和高于中位数的患者 5 年终点累积发生率分别为 8.5%和 19.4%（P=0.002，对数秩检验）。多变量 Cox 回归分析显示，cf-PWV 与白蛋白尿事件显著相关（HR 1.23，95%CI 1.13-1.33，P<0.001）。多元线性回归分析也表明 cf-PWV 与 eGFR 年变化率之间存在显著相关性（标准化估计值-0.095，P=0.031）。
主动脉僵硬与 2 型糖尿病患者白蛋白尿事件及肾小球滤过率下降率相关。
