Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Aging (Albany NY). 2021 Mar 3;13(6):8146-8154. doi: 10.18632/aging.202624.
Several studies show that patients with early-onset diabetes have higher risk of diabetic complications than those diagnosed in middle age. However, whether early-onset of type 2 diabetes mellitus (T2DM) is a risk factor for diabetic nephropathy (DN) progression remains unclear, especially a lack of data in biopsy-confirmed cohort. In This study, we enrolled 257 patients with T2DM and biopsy-confirmed DN to investigate the role of early-onset T2DM in DN progression. Participants were divided into two groups according to the age of T2DM diagnosis: early-onset group (less than 40 years) and later-onset group (40 years or older). We found that patients with early-onset T2DM had higher glomerular grades and arteriolar hyalinosis scores than those in later-onset group. After adjusted for confounding factors, early-onset of T2DM remained an independent predictor of end-stage renal disease (ESRD) for patients with DN. In conclusion, although with the comparable renal function and proteinuria, patients with early-onset T2DM and DN had worse renal pathological changes than those with later-onset. Early-onset of T2DM might be an important predictor of ESRD for patients with DN, which called more attention to early supervision and prevention for patients with early-onset T2DM and DN.
一些研究表明，早发糖尿病患者发生糖尿病并发症的风险高于中年发病者。然而，2 型糖尿病（T2DM）的早发是否是糖尿病肾病（DN）进展的危险因素尚不清楚，特别是在经活检证实的队列中缺乏数据。在这项研究中，我们纳入了 257 例 T2DM 合并经活检证实的 DN 患者，以探讨早发 T2DM 在 DN 进展中的作用。参与者根据 T2DM 诊断年龄分为两组：早发组（<40 岁）和晚发组（40 岁或以上）。我们发现，早发 T2DM 患者的肾小球分级和小动脉玻璃样变评分高于晚发组。在调整混杂因素后，早发 T2DM 仍然是 DN 患者发生终末期肾病（ESRD）的独立预测因素。总之，尽管两组患者的肾功能和蛋白尿相当，但早发 T2DM 合并 DN 患者的肾脏病理改变比晚发组更严重。早发 T2DM 可能是 DN 患者发生 ESRD 的重要预测因素，这呼吁对早发 T2DM 合并 DN 患者进行更早期的监测和预防。
