The Institute of Endocrinology and Diabetology, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Middle Wulumuqi Road, Shanghai 200040, China.
Int J Endocrinol. 2014;2014:351945. doi: 10.1155/2014/351945. Epub 2014 Aug 20.
Aims. Left ventricular hypertrophy (LVH) and albuminuria are both markers for cardiovascular diseases (CVDs) in patients with type 2 diabetes mellitus (T2DM). We speculate that albuminuria in T2DM patients with early diabetic kidney disease (DKD) could predict LVH. Methods. 333 diabetic patients (219 non-DKD and 114 early DKD) were enrolled. The association between albuminuria and LVMI was examined using multivariate linear regression and logistic regression. Results. The rate of LVH was significantly higher in patients with early DKD versus those without DKD (57.0% versus 32.9%; P < 0.001). Multivariate linear regression analysis demonstrated that albuminuria status (no, micro-, and macroalbuminuria; P < 0.001), age (P < 0.001), systolic blood pressure (P = 0.0578), and the use of ACEI/ARB drug (P < 0.001) were independently associated with LVMI. The risks were substantially higher for LVH in the microalbuminuria group (odds ratio 2.473 (95% confidence interval 1.370-4.464)) and macroalbuminuria group (odds ratio 3.940 (95% confidence interval 1.553-9.993)) compared with that in non-DKD group. Concentric hypertrophy was the most common geometric pattern in patients with early DKD (36.0%), followed by eccentric hypertrophy (21.0%). Conclusions. Albuminuria is associated with higher LVMI and higher rate of LVH in patients with early phase DKD.
左心室肥厚(LVH)和白蛋白尿都是 2 型糖尿病(T2DM)患者心血管疾病(CVD)的标志物。我们推测,早期糖尿病肾病(DKD)的 T2DM 患者的白蛋白尿可能预测 LVH。
纳入 333 名糖尿病患者(219 名非 DKD 和 114 名早期 DKD)。使用多元线性回归和逻辑回归检查白蛋白尿与 LVMI 之间的关系。
与无 DKD 患者相比,早期 DKD 患者的 LVH 发生率显著更高(57.0%比 32.9%;P<0.001)。多元线性回归分析表明,白蛋白尿状态(无、微量和大量白蛋白尿;P<0.001)、年龄(P<0.001)、收缩压(P=0.0578)和 ACEI/ARB 药物的使用(P<0.001)与 LVMI 独立相关。微量白蛋白尿组(比值比 2.473(95%置信区间 1.370-4.464))和大量白蛋白尿组(比值比 3.940(95%置信区间 1.553-9.993))的 LVH 风险显著高于非 DKD 组。早期 DKD 患者最常见的几何形态是向心性肥厚(36.0%),其次是离心性肥厚(21.0%)。
白蛋白尿与早期 DKD 患者的 LVMI 升高和 LVH 发生率升高相关。