Clinical Research Center, National Hospital Organization, Chiba-East National Hospital, 673 Nitona, Chuo-ku, Chiba City, Chiba, 260-8712, Japan.
J Diabetes Complications. 2013 Jan-Feb;27(1):92-7. doi: 10.1016/j.jdiacomp.2012.06.013. Epub 2012 Aug 10.
We examined the relationship between the brain natriuretic peptide (BNP) level and renal function in diabetic nephropathy with microalbuminuria.
The subjects were 97 Japanese type 2 diabetes mellitus outpatients with microalbuminuria. Associations between the annual rate of decline in estimated glomerular filtration rate (eGFR) and various metabolic parameters at baseline (BMI, systolic blood pressure, HbA1c, LDL cholesterol, urine albumin-creatinine ratio, BNP and eGFR) were examined.
Among the baseline factors, eGFR and BNP had significant associations with the annual rate of decline in eGFR in Pearson correlation analysis (r=0.295, p=0.003; r=0.223, p=0.028, respectively). Multiple linear regression analysis also showed the significance of baseline eGFR and BNP as independent predictors of renal function (β=0.340, p=0.001; β=0.278, p=0.005, respectively). In multivariate logistic regression analysis, eGFR and BNP were independently associated with the risk of a decline in GFR (p=0.003, p=0.011, respectively). ROC curve analysis showed a cutoff value of BNP is 17.0 pg/mL for predicting a decline in GFR.
The BNP level at baseline is an independent predictor of the annual rate of decline in eGFR. Therefore, monitoring of BNP can play an important role in management of diabetic nephropathy.
我们研究了脑钠肽（BNP）水平与伴微量白蛋白尿的糖尿病肾病患者肾功能之间的关系。
本研究纳入 97 例日本 2 型糖尿病伴微量白蛋白尿的门诊患者。在基线时（BMI、收缩压、HbA1c、LDL 胆固醇、尿白蛋白/肌酐比值、BNP 和 eGFR），我们分析了各代谢参数与估算肾小球滤过率（eGFR）年下降率之间的相关性。
在基线因素中，Pearson 相关分析显示 eGFR 和 BNP 与 eGFR 年下降率显著相关（r=0.295，p=0.003；r=0.223，p=0.028）。多元线性回归分析也显示基线 eGFR 和 BNP 是肾功能的独立预测因素（β=0.340，p=0.001；β=0.278，p=0.005）。在多元逻辑回归分析中，eGFR 和 BNP 与 GFR 下降风险独立相关（p=0.003，p=0.011）。ROC 曲线分析显示 BNP 的截断值为 17.0 pg/mL 时可预测 GFR 下降。
基线 BNP 水平是 eGFR 年下降率的独立预测因素。因此，监测 BNP 可以在糖尿病肾病的管理中发挥重要作用。
