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一项用于验证生物标志物的2型糖尿病患者前瞻性队列研究(PROVALID)——研究设计与基线特征

A Prospective Cohort Study in Patients with Type 2 Diabetes Mellitus for Validation of Biomarkers (PROVALID) - Study Design and Baseline Characteristics.

作者信息

Eder Susanne, Leierer Johannes, Kerschbaum Julia, Rosivall Laszlo, Wiecek Andrzej, de Zeeuw Dick, Mark Patrick B, Heinze Georg, Rossing Peter, Heerspink Hiddo L, Mayer Gert

机构信息

Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria.

International Nephrology Research and Training Center, Institute of Pathophysiology, Semmelweis University, Budapest, Hungary.

出版信息

Kidney Blood Press Res. 2018;43(1):181-190. doi: 10.1159/000487500. Epub 2018 Feb 16.

Abstract

BACKGROUND/AIMS: The prevalence of diabetes mellitus type 2 and kidney disease in these patients varies widely between European countries.

METHODS

In addition to store bio-samples the "Prospective cohort study in patients with type 2 diabetes mellitus for validation of biomarkers" collects information on history, physical status, laboratory measurements and medication in 4000 patients with diabetes mellitus type 2, being taken care of at the primary level of healthcare in 5 European countries (Austria, Hungary, Netherlands, Poland and Scotland). Next to comparing the rate of loss of eGFR between the countries, a further objective of the PROVALID study is to determine the 5-year cumulative incidence of renal and cardiovascular outcomes.

RESULTS

The mean age of the population recruited is 62.9±10 years, 54.6% are male and the mean BMI is 30.9±5.4 kg/m2. Metabolic control (median HBA1c 6.8 % (6.2; 7.5)) is achieved via administration of metformin in 67.4% of the patients and insulin in 30.3%. Median systolic and diastolic blood pressure at recruitment is 135 (125; 146) and 80 (72; 85) mmHg, 65.4% of subjects received RAAS blocking agents. Mean eGFR is 80.7±29.2 ml/min/1.73m2 and median baseline albumin/creatinine ratio 8.3 mg (IQR: 3.8 and 25.1).

CONCLUSION

PROVALID will provide information on incidence and progression of renal and cardiovascular disease and therapy in patients with type 2 diabetes mellitus in different European countries. Thus, in contrast to many other cohort studies we will be able to associate national clinical practise pattern with outcome in this highly vulnerable patient population.

摘要

背景/目的:2型糖尿病和肾病在这些患者中的患病率在欧洲国家之间差异很大。

方法

“2型糖尿病患者生物标志物验证前瞻性队列研究”除了储存生物样本外,还收集了4000例2型糖尿病患者的病史、身体状况、实验室检查结果和用药信息,这些患者在5个欧洲国家(奥地利、匈牙利、荷兰、波兰和苏格兰)的初级医疗保健机构接受治疗。除了比较各国估算肾小球滤过率(eGFR)下降率外,PROVALID研究的另一个目标是确定肾脏和心血管结局的5年累积发病率。

结果

招募人群的平均年龄为62.9±10岁,男性占54.6%,平均体重指数为30.9±5.4kg/m²。67.4%的患者通过服用二甲双胍实现代谢控制(糖化血红蛋白(HBA1c)中位数为6.8%(6.2;7.5)),30.3%的患者使用胰岛素。入组时收缩压和舒张压的中位数分别为135(125;146)和80(72;85)mmHg,65.4%的受试者接受了肾素-血管紧张素-醛固酮系统(RAAS)阻断剂治疗。平均eGFR为80.7±29.2ml/min/1.73m²,基线白蛋白/肌酐比值中位数为8.3mg(四分位间距:3.8和25.1)。

结论

PROVALID将提供不同欧洲国家2型糖尿病患者肾脏和心血管疾病的发病率、进展情况及治疗信息。因此,与许多其他队列研究不同,我们将能够把国家临床实践模式与这一高度脆弱患者群体的结局联系起来。

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