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抵抗素作为预测合并慢性肾脏病的糖尿病患者心血管住院和肾脏恶化的指标。

Resistin as a predictor of cardiovascular hospital admissions and renal deterioration in diabetic patients with chronic kidney disease.

机构信息

Nephrology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal.

Nephrology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal; Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal.

出版信息

J Diabetes Complications. 2019 Nov;33(11):107422. doi: 10.1016/j.jdiacomp.2019.107422. Epub 2019 Aug 22.

Abstract

BACKGROUND

High resistin levels have been associated with cardiovascular disease (CVD). Cardiovascular hospitalizations are common, especially in diabetic and renal impaired patients. The purpose of this study is to determine the role of serum resistin as a predictor of cardiovascular hospitalizations in type 2 diabetic patients with mild to moderate chronic kidney disease (CKD).

METHODS

We conducted a prospective, observational study. 78 diabetic patients with mild to moderate CKD and no previous CVD were included. The population was divided in two groups: G-1 with cardiovascular related admission (n = 13) and G-2 without cardiovascular related admission (n = 65). A Student's t-test was conducted to determine correlations between laboratory findings and hospitalization. We used logistic regression to assess predictors of cardiovascular events requiring hospitalization and Cox regression to identify predictors of end-stage renal disease (ESRD).

RESULTS

eGFR, albumin, HbA1c, phosphorous, PTH, IR, CRP, resistin and active vitamin D, were related to cardiovascular admissions. In a multivariate regression model, resistin (OR = 2.074, p = 0.047) was an independent predictor of cardiovascular hospitalization. Cox regression showed that resistin (HR = 1.931, p = 0.031) and UACr (HR = 1.151, p = 0.048) were also independent predictors of renal disease progression.

CONCLUSION

Resistin demonstrated to be valuable in predicting hospital admissions and progression to ESRD.

摘要

背景

高水平的抵抗素与心血管疾病(CVD)有关。心血管住院很常见,尤其是在糖尿病和肾功能受损的患者中。本研究的目的是确定血清抵抗素作为 2 型糖尿病合并轻度至中度慢性肾脏病(CKD)患者心血管住院的预测因子的作用。

方法

我们进行了一项前瞻性观察性研究。纳入了 78 名患有轻度至中度 CKD 且无既往 CVD 的糖尿病患者。人群分为两组:G-1 组为有心血管相关住院史(n=13),G-2 组为无心血管相关住院史(n=65)。采用 Student's t 检验确定实验室发现与住院之间的相关性。我们使用逻辑回归评估心血管事件需要住院的预测因子,使用 Cox 回归识别终末期肾病(ESRD)的预测因子。

结果

eGFR、白蛋白、HbA1c、磷、PTH、IR、CRP、抵抗素和活性维生素 D 与心血管住院相关。在多变量回归模型中,抵抗素(OR=2.074,p=0.047)是心血管住院的独立预测因子。Cox 回归显示,抵抗素(HR=1.931,p=0.031)和 UACr(HR=1.151,p=0.048)也是肾脏疾病进展的独立预测因子。

结论

抵抗素在预测住院和进展为 ESRD 方面具有重要价值。

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