Tatsumi Yukako, Morimoto Akiko, Soyano Fumie, Shimoda Tetsuo, Miyamatsu Naomi, Ohno Yuko, Sakaguchi Shiro
1Department of Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565 Japan.
2Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka Japan.
Diabetol Int. 2015 Sep 4;7(2):181-187. doi: 10.1007/s13340-015-0235-x. eCollection 2016 Jun.
To investigate the risk of decreased estimated glomerular filtration rate (eGFR) and proteinuria among individuals with borderline diabetes.
This 5-year cohort study involved 2849 participants aged 30-79 years without diabetes or chronic kidney disease at baseline (April 2008-March 2009). Participants were categorized into two groups-normoglycemia and borderline diabetes-based on the results of a 75-g oral glucose tolerance test at baseline. Participants underwent annual comprehensive medical check-ups during the follow-up period until March 2014. Main outcomes were defined as proteinuria ≥[1+] or eGFR <60 ml/min/1.73 m. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95 % confidence interval (CI) of eGFR <60 ml/min/1.73 m and proteinuria ≥[1+] for the borderline diabetes group compared with the normoglycemia group.
During the follow-up period, 335 individuals developed eGFR <60 ml/min/1.73 m and 136 individuals developed proteinuria ≥[1+]. Participants in the borderline diabetes group did not have a significantly higher risk of eGFR <60 ml/min/1.73 m or proteinuria ≥[1+] after multivariable adjustment. However, participants with borderline diabetes who were also diagnosed with borderline diabetes at the endpoint examination had a significantly higher risk of proteinuria ≥[1+] compared with participants with normoglycemia who also had normoglycemia at the endpoint examination; the HR (95 % CI) was 1.76 (1.11-2.78).
Persistent borderline diabetes significantly increases the risk of proteinuria.
探讨糖尿病前期个体估计肾小球滤过率（eGFR）降低和蛋白尿的风险。
这项为期5年的队列研究纳入了2849名年龄在30 - 79岁之间、基线时（2008年4月至2009年3月）无糖尿病或慢性肾脏病的参与者。根据基线时75克口服葡萄糖耐量试验结果，将参与者分为两组——血糖正常组和糖尿病前期组。在随访期间，参与者每年接受一次全面的医学检查，直至2014年3月。主要结局定义为蛋白尿≥[1+]或eGFR<60 ml/min/1.73 m²。采用Cox比例风险回归分析，估计糖尿病前期组与血糖正常组相比，eGFR<60 ml/min/1.73 m²和蛋白尿≥[1+]的风险比（HR）及95%置信区间（CI）。
在随访期间，335名个体出现eGFR<60 ml/min/1.73 m²，136名个体出现蛋白尿≥[1+]。多变量调整后，糖尿病前期组参与者发生eGFR<60 ml/min/1.73 m²或蛋白尿≥[1+]的风险没有显著升高。然而，在终点检查时仍诊断为糖尿病前期的参与者与在终点检查时血糖仍正常的血糖正常组参与者相比，蛋白尿≥[1+]的风险显著更高；HR（95%CI）为1.76（1.11 - 2.78）。
持续性糖尿病前期会显著增加蛋白尿的风险。
