Cheng Dong, Zhao Jiangtao, Jian Liguo, Ding Tongbin, Liu Shichao
a Department of Cardiology , the Second Affiliated of Hospital, Zhengzhou University , Zhengzhou , Henan Province , China.
Ren Fail. 2016 Sep;38(8):1218-23. doi: 10.1080/0886022X.2016.1207050. Epub 2016 Jul 12.
Previous studies found that red cell distribution width was related to adverse cardiovascular events. However, few studies reported the relationship between red cell distribution width and early-stage renal injury in pregnant women with gestational diabetes mellitus. Using a cross-sectional design, 334 pregnant women with gestational diabetes mellitus were enrolled according to the criterion of inclusion and exclusion. Demographic and clinical examination data were collected. Depended on the urine albumin, study population were divided into case group (n = 118) and control group (n = 216). Compared with control group, the case group tend to be higher red cell distribution width level (13.6 ± 0.9 vs.12.5 ± 0.6, p < 0.001). The red cell distribution width was positively associated with albuminuria creatinine ratio (r = 0.567, p < 0.001). Multiple logistic regressions showed that red cell distribution width was still associated with early-stage renal injury after adjusting for many other potential cofounders. Compared with the first quartile, the risk ratio of the second, the third and the fourth quartile were 1.38 (95%CI: 1.06-1.80), 1.57 (95%CI: 1.21-2.97), 2.71 (95%CI: 2.08-3.54), respectively. Besides, systolic blood pressure, estimated glomerular filtration rate, uric acid and blood urea nitrogen were also significantly associated with renal injury in gestational diabetes mellitus patients. The elevated red cell distribution width level might be a predictor of early-stage renal injury in pregnant women with gestational diabetes mellitus. As an easy and routine examination index, red cell distribution width may provide better clinical guidance when combined with other important indices.
以往研究发现红细胞分布宽度与不良心血管事件有关。然而，很少有研究报道妊娠糖尿病孕妇红细胞分布宽度与早期肾损伤之间的关系。采用横断面设计，根据纳入和排除标准招募了334例妊娠糖尿病孕妇。收集人口统计学和临床检查数据。根据尿白蛋白情况，将研究人群分为病例组（n = 118）和对照组（n = 216）。与对照组相比，病例组的红细胞分布宽度水平更高（13.6±0.9 vs.12.5±0.6，p < 0.001）。红细胞分布宽度与尿白蛋白肌酐比值呈正相关（r = 0.567，p < 0.001）。多因素logistic回归显示，在调整了许多其他潜在混杂因素后，红细胞分布宽度仍与早期肾损伤有关。与第一四分位数相比，第二、第三和第四四分位数的风险比分别为1.38（95%CI：1.06 - 1.80）、1.57（95%CI：1.21 - 2.97）、2.71（95%CI：2.08 - 3.54）。此外，收缩压、估计肾小球滤过率、尿酸和血尿素氮也与妊娠糖尿病患者的肾损伤显著相关。红细胞分布宽度水平升高可能是妊娠糖尿病孕妇早期肾损伤的一个预测指标。作为一项简单的常规检查指标，红细胞分布宽度与其他重要指标联合应用时可能提供更好的临床指导。
