Earle Kenneth A, Ng Lauren, White Sarah, Zitouni Karima
1 Thomas Addison Unit, St George's University Hospitals NHS Foundation Trust, London, UK.
2 St George's, University of London, London, UK.
Diab Vasc Dis Res. 2017 Jul;14(4):304-309. doi: 10.1177/1479164116687237. Epub 2017 Mar 9.
Recent data suggest that the higher risk of end-stage renal disease in women compared with men is associated with waist circumference. We investigated whether vascular stiffness which is linked to visceral fat accumulation is gender specific and associated with a loss in renal function.
We studied 166 patients with type 2 diabetes at high risk of progressive renal disease. A vascular stiffness index was derived from measurement of the peripheral arterial pulse waveform using infrared finger photoplethysmography. Multiple regression analysis was used to examine the relationship between vascular stiffness and traditional clinical and biochemical renal disease risk factors.
Women were of similar mean (standard deviation) age [61.6 (6.8) vs 60.0 (8.3) years; p = 0.444] and duration of diabetes [9.8 (7.2) vs 10.9 (8.1) years; p = 0.885] compared to men. Waist circumference was significantly associated with vascular stiffness [regression coefficient B = 0.15 (95% confidence interval: 0.06-2.24); p = 0.001]. There was a negative slope parameter for the relationship between glomerular filtration rate and vascular stiffness [ B = -0.15 (95% confidence interval: -0.22 to -0.09); p < 0.001] in women only.
In this cohort, early renal functional decline in women is linked to increased vascular stiffness which may be associated with visceral fat accumulation as determined by waist circumference.
近期数据表明，女性终末期肾病风险高于男性与腰围有关。我们研究了与内脏脂肪堆积相关的血管僵硬度是否存在性别差异，以及是否与肾功能丧失有关。
我们研究了166例有进展性肾病高风险的2型糖尿病患者。使用红外手指光电容积描记法测量外周动脉脉搏波形，得出血管僵硬度指数。采用多元回归分析来研究血管僵硬度与传统临床及生化肾病危险因素之间的关系。
与男性相比，女性的平均（标准差）年龄[61.6（6.8）岁对60.0（8.3）岁；p = 0.444]和糖尿病病程[9.8（7.2）年对10.9（8.1）年；p = 0.885]相似。腰围与血管僵硬度显著相关[回归系数B = 0.15（95%置信区间：0.06 - 2.24）；p = 0.001]。仅在女性中，肾小球滤过率与血管僵硬度之间的关系存在负斜率参数[B = -0.15（95%置信区间：-0.22至-0.09）；p < 0.001]。
在该队列中，女性早期肾功能下降与血管僵硬度增加有关，而血管僵硬度增加可能与腰围所确定的内脏脂肪堆积有关。
