Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.
Department of Internal Medicine, Busan St. Mary's Medical Center, Busan, Republic of Korea.
J Diabetes Res. 2017;2017:7047909. doi: 10.1155/2017/7047909. Epub 2017 Aug 16.
The aim of this study was to evaluate the association between arterial stiffness and albuminuria and glomerular filtration rate (GFR) in patients with type 2 diabetes mellitus.
This multicenter cohort study analyzed 2613 patients with type 2 diabetes. Brachial-ankle pulse wave velocity (baPWV) was used as a noninvasive marker of arterial stiffness. Additionally, the patients were categorized into four groups according to their albumin-to-creatinine ratio (ACR, normoalbuminuria versus albuminuria) and estimated GFR (eGFR, <60 mL/min/1.73 m versus ≥60 mL/min/1.73 m).
A univariate analysis revealed that maximal baPWV was significantly associated with both the ACR ( = 0.297, < 0.001) and eGFR ( = -0.220, < 0.001). A multivariate analysis adjusted for significant clinical variables and eGFR showed that baPWV remained significantly correlated with the ACR ( = 0.150, < 0.001). Also, baPWV was correlated positively with the ACR in patients with an eGFR ≥ 60 mL/min/1.73 m ( = 0.146, < 0.001). However, baPWV was not correlated with eGFR after adjustment for significant clinical variables.
The present findings indicate that arterial stiffness is more associated with albuminuria than a decrease in GFR in patients with type 2 diabetes mellitus.
本研究旨在评估 2 型糖尿病患者的动脉僵硬度与蛋白尿和肾小球滤过率（GFR）之间的关系。
这项多中心队列研究分析了 2613 例 2 型糖尿病患者。肱踝脉搏波速度（baPWV）被用作动脉僵硬度的无创标志物。此外，根据白蛋白与肌酐比值（ACR，正常白蛋白尿与白蛋白尿）和估算的 GFR（eGFR，<60mL/min/1.73m2 与≥60mL/min/1.73m2），患者被分为四组。
单变量分析显示，最大 baPWV 与 ACR（ = 0.297，<0.001）和 eGFR（ = -0.220，<0.001）均显著相关。调整重要临床变量和 eGFR 后的多变量分析显示，baPWV 与 ACR 仍显著相关（ = 0.150，<0.001）。此外，在 eGFR≥60mL/min/1.73m2 的患者中，baPWV 与 ACR 呈正相关（ = 0.146，<0.001）。然而，在调整重要临床变量后，baPWV 与 eGFR 无关。
本研究结果表明，在 2 型糖尿病患者中，动脉僵硬度与蛋白尿的相关性高于 GFR 的下降。
