中老年非2型糖尿病患者胰腺β细胞功能与微量白蛋白尿及肾小球滤过率的关系：一项基于中国社区的分析

Relationships of pancreatic beta-cell function with microalbuminuria and glomerular filtration rate in middle-aged and elderly population without type 2 diabetes mellitus: a Chinese community-based analysis.

作者信息

Fu Shihui, Zhou Shanjing, Luo Leiming, Ye Ping

机构信息

Department of Geriatric Cardiology.

Department of Cardiology and Hainan Branch.

出版信息

Clin Interv Aging. 2017 May 3;12:753-757. doi: 10.2147/CIA.S134496. eCollection 2017.

DOI:10.2147/CIA.S134496

PMID:28496313

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5422324/

Abstract

BACKGROUND

Relationships of pancreatic beta-cell function abnormality with microalbuminuria (MA) and glomerular filtration rate (GFR) may differ by age, ethnicity and accompanied diseases. Previous studies were generally conducted in Western adult patients with type 2 diabetes mellitus (T2DM), and it is uncertain whether pancreatic beta-cell function is associated with MA and GFR in Chinese community-dwelling middle-aged and elderly population without T2DM. We therefore examined the relationships of pancreatic beta-cell function with two indices of renal damage, MA and GFR, in Chinese community-dwelling middle-aged and elderly population without T2DM.

METHODS

This analysis focused on 380 Beijing residents older than 45 years who were free of T2DM and completed the evaluation of pancreatic beta-cell function.

RESULTS

Median age was 67 (49-80) years. Levels of triglyceride, diastolic blood pressure and homeostasis model assessment-beta (HOMA-beta) index were positively related to urine microalbumin (<0.05 for all). Age, low-density lipoprotein cholesterol levels and HOMA-beta index were inversely correlated with GFR, while high-density lipoprotein cholesterol levels were positively correlated with GFR (<0.05 for all). In all three adjustment models, there was a significant positive association between HOMA-beta index and MA; subjects with higher beta-cell function had higher odds of MA (<0.05 for all). There was no association between HOMA-beta index and GFR <60 mL/min/1.73 m in any model (>0.05 for all).

CONCLUSION

Modeling the pancreatic beta-cell function with different adjusted variables provided the same conclusion of association with MA; beta-cell function was positively associated with MA. Additionally, there was a specific difference in the adjusted associations of pancreatic beta-cell function with MA and GFR <60 mL/min/1.73 m; beta-cell function was not independently associated with GFR <60 mL/min/1.73 m. This result indicated that abnormal pancreatic beta-cell function plays an important role in the development of MA.

摘要

背景

胰腺β细胞功能异常与微量白蛋白尿（MA）及肾小球滤过率（GFR）之间的关系可能因年龄、种族和伴随疾病而异。既往研究通常在西方成年2型糖尿病（T2DM）患者中进行，而对于中国非T2DM社区中老年人群，胰腺β细胞功能是否与MA和GFR相关尚不确定。因此，我们在中国非T2DM社区中老年人群中研究了胰腺β细胞功能与两个肾损伤指标MA和GFR之间的关系。

方法

本分析聚焦于380名年龄大于45岁、无T2DM且完成胰腺β细胞功能评估的北京居民。

结果

中位年龄为67（49 - 80）岁。甘油三酯水平、舒张压和稳态模型评估β（HOMA-β）指数与尿微量白蛋白呈正相关（均P<0.05）。年龄、低密度脂蛋白胆固醇水平和HOMA-β指数与GFR呈负相关，而高密度脂蛋白胆固醇水平与GFR呈正相关（均P<0.05）。在所有三个校正模型中，HOMA-β指数与MA之间均存在显著正相关；β细胞功能较高的受试者发生MA的几率更高（均P<0.05）。在任何模型中，HOMA-β指数与GFR<60 mL/min/1.73 m均无关联（均P>0.05）。

结论

采用不同校正变量对胰腺β细胞功能进行建模，得出了与MA关联的相同结论；β细胞功能与MA呈正相关。此外，胰腺β细胞功能与MA及GFR<60 mL/min/1.73 m的校正关联存在特定差异；β细胞功能与GFR<60 mL/min/1.73 m无独立关联。这一结果表明，胰腺β细胞功能异常在MA的发生发展中起重要作用。