Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam College of Medicine, Daegu, Republic of Korea.
Kwon and Oh Internal Medicine, Sangju, Gyeongbuk, Republic of Korea.
Sci Rep. 2018 Jan 17;8(1):908. doi: 10.1038/s41598-018-19274-5.
Critical shear stress (CSS, mPa) is an index of red blood cell (RBC) aggregability, defined as the minimal shear stress required to disperse RBC aggregates. This study aimed to investigate the association between CSS and the risk of diabetic kidney disease (DKD). A total of 421 (mean age, 58.1 ± 11.5 years; male, 250) individuals with T2DM were enrolled and divided into three groups according to CSS level. CSS was measured using a transient microfluidic technique. DKD was defined as a glomerular filtration rate (GFR) <60 ml/min/1.73 m or a urine albumin-to-creatinine ratio (uACR) ≥30 mg/g. CSS was significantly higher in patients with DKD than in those without (317.43 ± 125.11 vs 385.22 ± 182.89, p < 0.001). Compared to the lowest CSS tertile, the highest CSS tertile was independently associated with the risk of DKD after adjusting for age, sex, duration of diabetes, presence of hypertension and haemoglobin. The cut-off value of CSS for DKD was approximately 310 mPa. These results suggest that haemorheologic changes may contribute to DKD, and further prospective studies are warranted to determine the role of CSS as a DKD screening tool.
临界切应力（CSS，毫帕斯卡）是红细胞（RBC）聚集性的指标，定义为分散 RBC 聚集物所需的最小切应力。本研究旨在探讨 CSS 与糖尿病肾病（DKD）风险之间的关系。共纳入 421 名（平均年龄 58.1±11.5 岁；男性 250 名）T2DM 患者，并根据 CSS 水平分为三组。使用瞬态微流技术测量 CSS。DKD 定义为肾小球滤过率（GFR）<60 ml/min/1.73 m 或尿白蛋白/肌酐比（uACR）≥30 mg/g。与无 DKD 患者相比，有 DKD 患者的 CSS 显著更高（317.43±125.11 对 385.22±182.89，p<0.001）。在校正年龄、性别、糖尿病病程、高血压和血红蛋白后，与最低 CSS 三分位相比，最高 CSS 三分位与 DKD 风险独立相关。用于 DKD 的 CSS 截断值约为 310 mPa。这些结果表明血液流变学变化可能导致 DKD，需要进一步的前瞻性研究来确定 CSS 作为 DKD 筛查工具的作用。
