肾小球滤过率和/或尿白蛋白与肌酐比值作为糖尿病视网膜病变的标志物：一项十年随访研究。
Glomerular Filtration Rate and/or Ratio of Urine Albumin to Creatinine as Markers for Diabetic Retinopathy: A Ten-Year Follow-Up Study.
机构信息
Ophthalmology Service, University Hospital Sant Joan, Institut de Investigacio Sanitaria Pere Virgili (IISPV), Universitat Rovira & Virgili, Reus, Spain.
Department of Computer Engineering and Mathematics, Universitat Rovira & Virgili, Reus, Spain.
出版信息
J Diabetes Res. 2018 Feb 26;2018:5637130. doi: 10.1155/2018/5637130. eCollection 2018.
AIMS
To determine the relationship between diabetic nephropathy and diabetic retinopathy on a population of type 2 diabetes mellitus patients.
METHODS
A prospective ten-year follow-up population-based study. We determined differences between estimated glomerular filtration rate (eGFR) using the chronic kidney disease epidemiology collaboration equation and urine albumin to creatinine ratio.
RESULTS
Annual incidence of any-DR was 8.21 ± 0.60% (7.06%-8.92%), sight-threatening diabetic retinopathy (STDR) was 2.65 ± 0.14% (2.48%-2.88%), and diabetic macular edema (DME) was 2.21 ± 0.18% (2%-2.49%). Renal study results were as follows: UACR > 30 mg/g had an annual incidence of 7.02 ± 0.05% (6.97%-7.09%), eGFR < 60 ml/min/1.73 m incidence was 5.89 ± 0.12% (5.70%-6.13%). Cox's proportional regression analysis of DR incidence shows that renal function studied by eGFR < 60 ml/min/1.73 m was less significant ( = 0.04, HR 1.223, 1.098-1.201) than UACR ≥ 300 mg/g ( < 0.001, HR 1.485, 1.103-1.548). The study of STDR shows that eGFR < 60 ml/min/1.73 m was significant ( = 0.02, HR 1.890, 1.267-2.820), UACR ≥ 300 mg/g ( < 0.001, HR 2.448, 1.595-3.757), and DME shows that eGFR < 60 ml/min/1.73 m was significant ( = 0.02, HR 1.920, 1.287-2.864) and UACR ≥ 300 mg/g ( < 0.001, HR 2.432, 1.584-3.732).
CONCLUSIONS
The UACR has a better association with diabetic retinopathy than the eGFR, although both are important risk factors for diabetic retinopathy.
目的
在 2 型糖尿病患者人群中，确定糖尿病肾病和糖尿病视网膜病变之间的关系。
方法
这是一项前瞻性十年随访的基于人群的研究。我们比较了使用慢性肾脏病流行病学合作方程估计的肾小球滤过率（eGFR）与尿白蛋白与肌酐比值之间的差异。
结果
任何糖尿病视网膜病变（DR）的年发生率为 8.21±0.60%（7.06%-8.92%），威胁视力的糖尿病视网膜病变（STDR）为 2.65±0.14%（2.48%-2.88%），糖尿病黄斑水肿（DME）为 2.21±0.18%（2%-2.49%）。肾脏研究结果如下：UACR＞30mg/g 的年发生率为 7.02±0.05%（6.97%-7.09%），eGFR＜60ml/min/1.73m2 的发生率为 5.89±0.12%（5.70%-6.13%）。DR 发生率的 Cox 比例回归分析显示，eGFR＜60ml/min/1.73m2 对肾功能的研究意义较小（=0.04，HR 1.223，1.098-1.201），而 UACR≥300mg/g（＜0.001，HR 1.485，1.103-1.548）则意义更大。对 STDR 的研究表明，eGFR＜60ml/min/1.73m2 有显著意义（=0.02，HR 1.890，1.267-2.820），UACR≥300mg/g（＜0.001，HR 2.448，1.595-3.757），而 DME 则显示 eGFR＜60ml/min/1.73m2 有显著意义（=0.02，HR 1.920，1.287-2.864），UACR≥300mg/g（＜0.001，HR 2.432，1.584-3.732）。
结论
UACR 与糖尿病视网膜病变的相关性优于 eGFR，尽管两者都是糖尿病视网膜病变的重要危险因素。
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