Furukawa Shinya, Sakai Takenori, Niiya Tetsuji, Miyaoka Hiroaki, Miyake Teruki, Yamamoto Shin, Tanaka Keiko, Ueda Teruhisa, Senba Hidenori, Torisu Masamoto, Minami Hisaka, Matsuura Bunzo, Hiasa Yoichi, Miyake Yoshihiro
Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan.
Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Toon, Japan.
Endocr J. 2017 Dec 28;64(12):1131-1136. doi: 10.1507/endocrj.EJ17-0256. Epub 2017 Aug 31.
Among patients with type 2 diabetes mellitus, the association between B-type natriuretic peptide (BNP) and renal function remains controversial. We therefore investigated this issue among Japanese patients with type 2 diabetes mellitus. This study included 687 Japanese patients with type 2 diabetes mellitus. BNP levels were divided at quartile points on the basis of the distribution. We used four outcomes regarding the renal function: 1) chronic kidney disease (CKD): estimated glomerular filtration rate (eGFR) < 60ml/min/1.72m, 2) advanced CKD: eGFR < 30ml/min/1.72m, 3) microalbuminuria: urinary albumin creatinine ratio (UACR) ≥ 30 mg/g creatinine, and 4) macroalbuminuria: UACR ≥ 300 mg/g creatinine. The prevalence values of CKD, advanced CKD, microalbuminuria, and macroalbuminuria were 27.4％, 2.5%, 31.4%, and 9.3%, respectively. Highest BNP (≥ 39.2 ng/ml) was independently positively associated with microalbuminuria and macroalbuminuria (adjusted ORs, 2.61 [95% CI: 1.53-4.49] and 3.45 [95% CI: 1.46-8.72], respectively). High BNP was not associated with advanced CKD or CKD. There was a statistically significant positive exposure-response relationships between the BNP level and advanced CKD, microalbuminuria, and macroalbuminuria (p for trend = 0.047, 0.001, and 0.003, respectively). BNP level may be independently positively associated with advanced CKD, microalbuminuria, and macroalbuminuria but not CKD in Japanese patients with type 2 diabetes mellitus.
在2型糖尿病患者中，B型利钠肽（BNP）与肾功能之间的关联仍存在争议。因此，我们在日本2型糖尿病患者中对这一问题进行了调查。本研究纳入了687例日本2型糖尿病患者。根据分布情况，将BNP水平分为四分位数。我们使用了四项与肾功能相关的指标：1）慢性肾脏病（CKD）：估算肾小球滤过率（eGFR）<60ml/min/1.72m²；2）晚期CKD：eGFR<30ml/min/1.72m²；3）微量白蛋白尿：尿白蛋白肌酐比值（UACR）≥30mg/g肌酐；4）大量白蛋白尿：UACR≥300mg/g肌酐。CKD、晚期CKD、微量白蛋白尿和大量白蛋白尿的患病率分别为27.4％、2.5%、31.4%和9.3%。最高BNP（≥39.2ng/ml）与微量白蛋白尿和大量白蛋白尿独立正相关（校正后的比值比分别为2.61[95%置信区间：1.53 - 4.49]和3.45[95%置信区间：1.46 - 8.72]）。高BNP与晚期CKD或CKD无关。BNP水平与晚期CKD、微量白蛋白尿和大量白蛋白尿之间存在统计学上显著的正暴露 - 反应关系（趋势p值分别为0.047、0.001和0.003）。在日本2型糖尿病患者中，BNP水平可能与晚期CKD、微量白蛋白尿和大量白蛋白尿独立正相关，但与CKD无关。
