Jiang Jun, Lan Lei, Zhou Xiaowan, Peng Li, Ren Wei
Department of Nephrology, Anhui Provincal Hospital, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), University of Science and Technology of China, Hefei, China.
Intern Med J. 2018 Jul;48(7):830-835. doi: 10.1111/imj.13767.
BACKGROUND/AIM: Recent studies have shown that low haemoglobin (Hb) levels promote the progression of chronic kidney disease. This study assessed the relationship between Hb level and type 1 diabetic nephropathy (DN) in Han patients in Anhui, China.
There was a total of 236 patients diagnosed with type 1 diabetes mellitus (T1DM) seen between January 2014 and December 2016 in our centre. Haemoglobin levels in patients with DN were compared with those without DN. The relationship between Hb level and the urinary albumin-creatinine ratio (ACR) was examined by Spearman's correlational analysis and multiple stepwise regression analysis. The binary logistic multivariate regression analysis was performed to analyse the correlated factors for type 1 DN, calculate the odds ratio (OR) and 95% confidence interval (CI). The predicting value of Hb level for DN was evaluated by area under receiver operation characteristic curve (AUROC) for discrimination and Hosmer-Lemeshow goodness-of-fit test for calibration.
The average Hb levels in the DN group (116.1 ± 20.8 g/L) were significantly lower than the non-DN group (131.9 ± 14.4 g/L), P < 0.001. Hb levels were independently correlated with the urinary ACR in multiple stepwise regression analysis. The logistic multivariate regression analysis showed that the Hb level (OR: 0.936, 95% CI: 0.910-0.963, P < 0.001) was inversely correlated with DN in patients with T1DM. In sub-analysis, low Hb level (Hb < 120 g/L in female, Hb < 130 g/L in male) was still negatively associated with DN in patients with T1DM. The AUROC was 0.721 (95% CI: 0.655-0.787) in assessing the discrimination of the Hb level for DN. The value of P was 0.593 in Hosmer-Lemeshow goodness-of-fit test.
In patients with T1DM, the Hb level is inversely correlated with urinary ACR and DN.
背景/目的：近期研究表明，低血红蛋白（Hb）水平会促进慢性肾脏病的进展。本研究评估了中国安徽汉族患者的Hb水平与1型糖尿病肾病（DN）之间的关系。
2014年1月至2016年12月期间，本中心共诊断出236例1型糖尿病（T1DM）患者。比较了DN患者与非DN患者的血红蛋白水平。通过Spearman相关分析和多元逐步回归分析研究Hb水平与尿白蛋白肌酐比值（ACR）之间的关系。进行二元逻辑多元回归分析以分析1型DN的相关因素，计算比值比（OR）和95%置信区间（CI）。通过受试者工作特征曲线下面积（AUROC）评估Hb水平对DN的鉴别预测价值，并通过Hosmer-Lemeshow拟合优度检验进行校准。
DN组的平均Hb水平（116.1±20.8 g/L）显著低于非DN组（131.9±14.4 g/L），P<0.001。在多元逐步回归分析中，Hb水平与尿ACR独立相关。逻辑多元回归分析显示，Hb水平（OR：0.936，95%CI：0.910-0.963，P<0.001）与T1DM患者的DN呈负相关。在亚组分析中，低Hb水平（女性Hb<120 g/L，男性Hb<130 g/L）仍与T1DM患者的DN呈负相关。评估Hb水平对DN的鉴别时，AUROC为0.721（95%CI：0.655-0.787）。Hosmer-Lemeshow拟合优度检验的P值为0.593。
在T1DM患者中，Hb水平与尿ACR和DN呈负相关。
