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检测中国 2 型糖尿病患者中 SUDOSCAN 与估计肾小球滤过率(eGFR)之间的关系。

Detection of relationships between SUDOSCAN with estimated glomerular filtration rate (eGFR) in Chinese patients with type 2 diabetes.

机构信息

Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.

Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Diabetes Res Clin Pract. 2018 Apr;138:113-118. doi: 10.1016/j.diabres.2018.01.036. Epub 2018 Feb 3.

Abstract

OBJECTIVE

SUDOSCAN (Impeto Medical, Paris, France) has been proved to be a new and non-invasive method in detecting renal dysfunction in type 2 diabetes mellitus (T2DM) patients. In this study, we sought to compare the result of diabetic kidney dysfunction score (DKD-score) of SUDOSCAN with estimated glomerular filtration rate (eGFR) by using quantile regression analysis, which was completely different from previous studies.

METHODS

A total number of 223 Chinese T2DM patients were enrolled in the study. SUDOSCAN, renal function test (including blood urea nitrogen, creatinine and uric acid) and mTc-diethylenetriamine pentaacetic acid (mTc-DTPA) renal dynamic imaging were performed in all T2DM patients. DKD-score of SUDOSCAN was compared with eGFR detected by mTc-DTPA renal dynamic imaging through quantile regression analysis. Its validation and utility was further determined through bias and precision test.

RESULTS

The quantile regression analysis demonstrated the relationship with eGFR was inverse and significant for almost all percentiles of DKD-score. The coefficients decreased as the percentile of DKD-score increased. And in validation data set, both the bias and precision were increased with the eGFR (median difference, -21.2 ml/min/1.73 m for all individuals vs. -4.6 ml/min/1.73 m for eGFR between 0 and 59 ml/min/1.73 m; interquartile range [IQR] for the difference, -25.4 ml/min/1.73 m vs. -14.7 ml/min/1.73 m). The eGFR category misclassification rate were 10% in eGFR 0-59 ml/min/1.73 m group, 57.3% in 60-90 group, and 87.2% in eGFR > 90 ml/min/1.73 m group.

CONCLUSION

DKD-score of SUDOSCAN could be used to detect renal dysfunction in T2DM patients. A higher prognostic value of DKD-score was detected when eGFR level was lower.

摘要

目的

SUDOSCAN(法国巴黎 Impeto 医疗公司)已被证明是一种新的非侵入性方法,可用于检测 2 型糖尿病(T2DM)患者的肾功能障碍。在这项研究中,我们试图通过使用分位数回归分析来比较 SUDOSCAN 的糖尿病肾病功能障碍评分(DKD-score)与估算肾小球滤过率(eGFR)的结果,这与之前的研究完全不同。

方法

共纳入 223 例中国 T2DM 患者。所有 T2DM 患者均行 SUDOSCAN、肾功能检查(包括血尿素氮、肌酐和尿酸)和 mTc-二乙三胺五乙酸(mTc-DTPA)肾动态成像。通过分位数回归分析比较 SUDOSCAN 的 DKD-score 与 mTc-DTPA 肾动态成像检测的 eGFR。通过偏差和精度检验进一步确定其验证和实用性。

结果

分位数回归分析表明,DKD-score 与 eGFR 的关系几乎在所有分位数上都是负相关且显著的。随着 DKD-score 分位数的增加,系数减小。在验证数据集中,随着 eGFR 的增加,偏差和精度均增加(所有个体的中位数差值为-21.2ml/min/1.73m2 与 eGFR 在 0-59ml/min/1.73m2 之间为-4.6ml/min/1.73m2;差值的四分位距[IQR]为-25.4ml/min/1.73m2 与-14.7ml/min/1.73m2)。eGFR 0-59ml/min/1.73m2 组的 eGFR 分类错误率为 10%,60-90ml/min/1.73m2 组为 57.3%,eGFR>90ml/min/1.73m2 组为 87.2%。

结论

SUDOSCAN 的 DKD-score 可用于检测 T2DM 患者的肾功能障碍。当 eGFR 水平较低时,DKD-score 的预后价值更高。

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