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代谢综合征和合并的糖尿病与原发性肾小球疾病患者心血管合并症风险增加相关:一项回顾性观察研究。

Metabolic syndrome and concomitant diabetes mellitus are associated with higher risk of cardiovascular comorbidity in patients with primary glomerular diseases: A retrospective observational study.

机构信息

The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.

Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

出版信息

Clin Cardiol. 2020 Sep;43(9):949-956. doi: 10.1002/clc.23388. Epub 2020 May 29.

Abstract

BACKGROUND

Metabolic syndrome (MS) and diabetes mellitus (DM) are risk factors for cardiovascular diseases in general population. However, there was a paucity of studies investigating their impact in primary glomerular diseases (PGD).

HYPOTHESIS

MS and concomitant DM are associated with higher risk of cardiovascular comorbidity in PGD.

METHODS

In a retrospective observational design, we analyzed 3622 hospitalized adult PGD patients and compared the prevalence of cardiovascular comorbidity in non-MS, MS with and without DM. Risk factors for cardiovascular comorbidity were identified using univariate and multivariate logistic regression.

RESULTS

Among 3622 PGD patients, 308 (8.5%) cases accompanied with MS, including 180 (5.0%) patients with DM and 128 (3.5%) without DM. One hundred and sixty four (4.5%) cases coexisted with cardiovascular comorbidity. Patients with MS and concomitant DM exhibited a higher prevalence of cardiovascular comorbidity than those without MS stratified by estimated glomerular filtration rate and pathological types. Logistic regression showed that MS and concomitant DM (OR: 2.496, 95% CI: 1.600-3.894, P < .001), older age (OR: 1.060, 95% CI: 1.047-1.074, P < .001), male (OR: 1.536, 95% CI: 1.072-2.200, P = .019), higher level of serum ti (OR: 1.002, 95% CI: 1.001-1.003, P < .001), hyperuricemia (OR: 1.901, 95% CI: 1.327-2.725, P < .001), idiopathic membranous nephropathy (OR: 2.874, 95% CI: 1.244-6.640, P < .001) and focal segmental glomerulosclerosis (OR: 2.906, 95% CI: 1.147-7.358, P < .001) were independently associated with a higher risk for cardiovascular comorbidity.

CONCLUSIONS

In PGD patients, MS and concomitant DM are associated with an increased risk for cardiovascular comorbidity. More evidence for the causal link between MS/DM and cardiovascular outcomes is needed to be clarified.

摘要

背景

代谢综合征(MS)和糖尿病(DM)是一般人群心血管疾病的危险因素。然而,很少有研究调查它们在原发性肾小球疾病(PGD)中的影响。

假说

MS 和并发 DM 与 PGD 中的心血管合并症风险增加相关。

方法

在回顾性观察设计中,我们分析了 3622 名住院成年 PGD 患者,并比较了非 MS、MS 伴或不伴 DM 患者的心血管合并症患病率。使用单变量和多变量逻辑回归确定心血管合并症的危险因素。

结果

在 3622 名 PGD 患者中,308 例(8.5%)伴有 MS,其中 180 例(5.0%)患有 DM,128 例(3.5%)无 DM。164 例(4.5%)存在心血管合并症。与非 MS 患者相比,MS 伴 DM 的患者肾小球滤过率和病理类型分层的心血管合并症患病率更高。逻辑回归显示,MS 和并发 DM(OR:2.496,95%CI:1.600-3.894,P<.001)、年龄较大(OR:1.060,95%CI:1.047-1.074,P<.001)、男性(OR:1.536,95%CI:1.072-2.200,P=.019)、血清 ti 水平较高(OR:1.002,95%CI:1.001-1.003,P<.001)、高尿酸血症(OR:1.901,95%CI:1.327-2.725,P<.001)、特发性膜性肾病(OR:2.874,95%CI:1.244-6.640,P<.001)和局灶节段性肾小球硬化症(OR:2.906,95%CI:1.147-7.358,P<.001)与心血管合并症风险增加独立相关。

结论

在 PGD 患者中,MS 和并发 DM 与心血管合并症风险增加相关。需要更多证据来阐明 MS/DM 与心血管结局之间的因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c12/8101350/379d776a6c76/CLC-43-949-g002.jpg

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