Kawabata Nao, Kawamura Tetsuya, Utsunomiya Kazunori, Kusano Eiji
Department of Clinical Nutrition, Jichi Medical University Hospital, Japan.
Intern Med. 2015;54(3):311-7. doi: 10.2169/internalmedicine.54.2464.
The aim of our study was to investigate clinical and nutritional factors associated with renal involvement in patients with type 2 diabetes.
We performed a cross-sectional study of 71 patients with type 2 diabetes who were being educated at our hospital from September 2006 to February 2008. The patients were divided into two groups; Group I consisted of 40 patients with both an estimated glomerular filtration rate (eGFR) of ≥ 60 mL/min/1.73 m(2) and normoalbuminuria, and Group II consisted of 31 patients with either microalbuminuria/overt proteinuria or an eGFR of <60 mL/min/1.73 m(2). We compared the age, body mass index (BMI), blood pressure, duration from onset of diabetes, use of hypoglycemic agents and insulin, biochemistry data, including HbA1c, pulse wave velocity corrected by blood pressure (PWVc) and the daily intake of several nutrients between the two groups. A multivariate logistic regression analysis was performed to identify factors independently associated with renal involvement.
Group II had significantly higher values for BMI, the duration of diabetes, triglycerides, uric acid and PWVc than Group I. Group II tended to have a high salt intake compared to Group I. The multivariate logistic analysis revealed that the daily salt intake, PWVc and uric acid were independent factors associated with renal involvement (odds ratio, 1.15, 1.84 and 2.00; 95% confidence interval, 1.02-1.31, 1.04-3.27 and 1.04-3.85, respectively).
Our data suggest that a high salt intake, in addition to arteriosclerosis, is associated with renal involvement in our cohort with type 2 diabetes.
本研究旨在调查2型糖尿病患者肾脏受累的临床及营养因素。
我们对2006年9月至2008年2月在我院接受教育的71例2型糖尿病患者进行了横断面研究。患者分为两组；第一组由40例估计肾小球滤过率（eGFR）≥60 mL/（min·1.73 m²）且尿白蛋白正常的患者组成，第二组由31例微量白蛋白尿/显性蛋白尿患者或eGFR<60 mL/（min·1.73 m²）的患者组成。我们比较了两组患者的年龄、体重指数（BMI）、血压、糖尿病病程、降糖药和胰岛素的使用情况、生化数据，包括糖化血红蛋白（HbA1c）、经血压校正的脉搏波速度（PWVc）以及几种营养素的每日摄入量。进行多因素逻辑回归分析以确定与肾脏受累独立相关的因素。
第二组患者的BMI、糖尿病病程、甘油三酯、尿酸和PWVc值显著高于第一组。与第一组相比，第二组患者的盐摄入量往往较高。多因素逻辑分析显示，每日盐摄入量、PWVc和尿酸是与肾脏受累相关的独立因素（比值比分别为1.15、1.84和2.00；95%置信区间分别为1.02 - 1.31、1.04 - 3.27和1.04 - 3.85）。
我们的数据表明，除动脉硬化外，高盐摄入与我们队列中的2型糖尿病患者肾脏受累有关。
