Fu Shihui, Zhou Shanjing, Luo Leiming, Ye Ping
Department of Geriatric Cardiology.
Department of Cardiology and Hainan Branch.
Clin Interv Aging. 2017 May 3;12:753-757. doi: 10.2147/CIA.S134496. eCollection 2017.
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.
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.
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).
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.
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。
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。
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)。
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。