Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China.
Department of Endocrinology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), Chengdu, China.
High Alt Med Biol. 2020 Dec;21(4):396-405. doi: 10.1089/ham.2020.0076. Epub 2020 Nov 12.
Zhao, Lijun, Xi Wang, Tingli Wang, Wenxin Fan, Honghong Ren, Rui Zhang, Yutong Zou, Huan Xu, Jie Zhang, Yunhong Wu, and Fang Liu. Associations between high-altitude residence and end-stage kidney disease in Chinese patients with type 2 diabetes. . 21:396-405, 2020. This study investigated whether living at high altitude was associated with progression to end-stage kidney disease (ESKD) in Chinese patients with diabetic nephropathy (DN). This retrospective study included 369 patients with type 2 diabetes mellitus (T2DM) and biopsy-confirmed DN. Cox proportional hazards models were used to estimate hazard ratios (HRs) for the influence of living at high altitude on ESKD. Patients living at ≥2,000 m above sea level were more likely to be Tibetan, and they had higher mean body mass indexes, glycosylated hemoglobin, hemoglobin concentrations, and baseline estimated glomerular filtration rates than those living at lower altitudes. During a median follow-up period of 20 months, 141 (38%) patients progressed to ESKD. In multivariable Cox analysis adjusted for age, sex, ethnicity, and clinical and pathological parameters, living at high altitude was independently associated with progression to ESKD in Chinese DN patients [HR 2.83, 95% confidence interval (CI) 1.05-7.58]. Compared with Han Chinese, Tibetans were at a lower risk of progression to ESKD (HR 0.15, 95% CI 0.04-0.59). Living at high altitude was independently associated with renal outcome in Han Chinese patients with T2DM and DN, but not native Tibetans.
赵立军，王锡，王婷丽，范文心，任红红，张蕊，邹玉彤，许欢，张杰，吴红云，刘芳。高海拔居住与中国 2 型糖尿病患者终末期肾病的关系。. 21:396-405, 2020. 本研究旨在探讨中国糖尿病肾病（DN）患者居住在高海拔地区是否与终末期肾病（ESKD）的进展有关。 本回顾性研究纳入了 369 例 2 型糖尿病（T2DM）和经活检证实的 DN 患者。使用 Cox 比例风险模型估计了居住在高海拔地区对 ESKD 的影响的风险比（HR）。 居住在 2000 米以上的患者更可能是藏族人，与居住在低海拔地区的患者相比，他们的平均体重指数、糖化血红蛋白、血红蛋白浓度和基线估算肾小球滤过率更高。在中位数为 20 个月的随访期间，141 例（38%）患者进展为 ESKD。在调整年龄、性别、种族以及临床和病理参数的多变量 Cox 分析中，居住在高海拔地区与中国 DN 患者进展为 ESKD 独立相关[HR 2.83，95%置信区间（CI）1.05-7.58]。与汉族相比，藏族患者进展为 ESKD 的风险较低（HR 0.15，95%CI 0.04-0.59）。 居住在高海拔地区与汉族 T2DM 和 DN 患者的肾脏结局独立相关，但与藏族人无关。
