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一项调查糖耐量受损的年轻成年人慢性肾病累积发病率的系统评价。

A systematic review investigating the cumulative incidence of chronic kidney disease in young adults with impaired glucose tolerance.

作者信息

Jadhakhan Ferozkhan, Marshall Tom, Gill Paramjit

机构信息

Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.

出版信息

Syst Rev. 2015 May 13;4:69. doi: 10.1186/s13643-015-0059-6.

Abstract

BACKGROUND

It is known that risk of chronic kidney disease (CKD) is elevated in patients with diabetes mellitus but it is not clear whether the risk is also elevated with impaired glucose tolerance (IGT). If the risk is increased, it is not known if this is confined to people with IGT who progress to type 2 diabetes (T2DM). The purpose of this systematic review is to determine the relative risk of CKD in young adults (aged 18 to 40 years) with IGT (exposed group) compared to those without glycaemic abnormality (comparator group).

METHODS/DESIGN: The following electronic databases will be systematically searched from inception to January 2015 for relevant studies: CINAHL, EMBASE, MEDLINE, PubMed, Cochrane libraries and grey literature. Two independent reviewers will screen search results, extract data, select studies for inclusion and assess their quality. Studies including young adults (aged 18 to 40 years) with IGT containing any of the following CKD markers will be included: estimated glomerular filtration rate (eGFR), albumin creatinine ratio (ACR), protein creatinine ratio (PCR), serum creatinine (SCr) and creatinine clearance (CrCl) levels. Studies at any time period after diagnosis of IGT and with any length of follow-up will be included. The proportion of IGT participants reporting each outcome will be documented. Relative risks (RR) and odds ratios (OR) will be extracted or calculated from raw data. If possible, study results will be combined in a meta-analysis.

DISCUSSION

The results of this comprehensive review will establish the evidence for the association between IGT and the risk of developing CKD in young adults (aged 18 to 40 years).

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42014007081.

摘要

背景

已知糖尿病患者患慢性肾脏病(CKD)的风险会升高,但糖耐量受损(IGT)患者的风险是否也会升高尚不清楚。如果风险增加,也不清楚这是否仅限于进展为2型糖尿病(T2DM)的IGT患者。本系统评价的目的是确定与无血糖异常者(对照组)相比,IGT的年轻成年人(18至40岁)(暴露组)患CKD的相对风险。

方法/设计:从数据库建立至2015年1月,将对以下电子数据库进行系统检索以查找相关研究:护理学与健康领域数据库(CINAHL)、荷兰医学文摘数据库(EMBASE)、医学索引数据库(MEDLINE)、医学期刊数据库(PubMed)、考克兰图书馆及灰色文献。两名独立的评审员将筛选检索结果、提取数据、选择纳入研究并评估其质量。纳入的研究需包括18至40岁患有IGT且包含以下任何一种CKD标志物的年轻成年人:估计肾小球滤过率(eGFR)、白蛋白肌酐比值(ACR)、蛋白肌酐比值(PCR)、血清肌酐(SCr)和肌酐清除率(CrCl)水平。将纳入IGT诊断后任何时间段且随访时间任意长度的研究。将记录报告各结局的IGT参与者比例。将从原始数据中提取或计算相对风险(RR)和比值比(OR)。如有可能,将在荟萃分析中合并研究结果。

讨论

这项全面综述的结果将为IGT与年轻成年人(18至40岁)患CKD风险之间的关联建立证据。

系统评价注册

国际前瞻性系统评价注册库(PROSPERO)注册号CRD42014007081。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c70/4433064/98075e89a7be/13643_2015_59_Fig1_HTML.jpg

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