Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan.
Diabetes Care. 2011 Dec;34(12):2557-9. doi: 10.2337/dc11-1039. Epub 2011 Oct 12.
To clarify the association of serum leptin levels with progression of diabetic kidney disease in patients with type 2 diabetes (T2D).
This was an observational cohort study of 668 patients with T2D. Patients were classified into three groups by sex-specific tertile of leptin levels. Outcome measurements were the rate of change in estimated glomerular filtration rate (eGFR) and progression to a more advanced stage of albuminuria.
Patients with low or high leptin levels had a steeper eGFR decline (-2.07 and -2.14 mL/min/1.73 m(2)/year) than those with midrange leptin levels (-0.82 mL/min/1.73 m(2)/year; P < 0.01), whereas patients with low leptin levels had an elevated risk of progression of albuminuria as compared with those with high leptin levels (hazard ratio 3.125 [95% CI 1.302-7.499]).
Both low and high serum leptin levels were risk factors for kidney function decline. Meanwhile, lower serum leptin levels were associated with progression of albuminuria.
阐明血清瘦素水平与 2 型糖尿病患者糖尿病肾病进展的相关性。
这是一项观察性队列研究，共纳入 668 例 2 型糖尿病患者。根据瘦素水平的性别三分位，将患者分为三组。结局测量指标为估算肾小球滤过率（eGFR）的变化率和向更严重蛋白尿阶段的进展情况。
与中值瘦素水平（-0.82 mL/min/1.73 m(2)/年）相比，低或高瘦素水平的患者 eGFR 下降速度更快（分别为-2.07 和-2.14 mL/min/1.73 m(2)/年；P<0.01），而低瘦素水平的患者发生蛋白尿进展的风险高于高瘦素水平的患者（风险比 3.125[95%CI 1.302-7.499]）。
低和高血清瘦素水平均为肾功能下降的危险因素。同时，较低的血清瘦素水平与蛋白尿进展相关。
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