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脂质蓄积产物与中国糖尿病前期人群的尿白蛋白肌酐比值相关:“瑞行动”研究报告

Lipid Accumulation Product is Associated with Urinary Albumin-creatinine Ratio in Chinese Prediabitic Population: A Report from the REACTION Study.

作者信息

Liu Yang, Wang Yun, Wang Jie, Chen Kang, Jin Lingzi, Wang Weiqing, Gao Zhengnan, Tang Xulei, Yan Li, Wan Qin, Luo Zuojie, Qin Guijun, Chen Lulu, Mu Yiming

机构信息

Graduate School, Chinese PLA General Hospital, Beijing, People's Republic of China.

Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2021 May 28;14:2415-2425. doi: 10.2147/DMSO.S310751. eCollection 2021.

Abstract

BACKGROUND

Lipid accumulation product (LAP) as a powerful marker of visceral obesity is an independent risk factor of chronic kidney disease. The present study attempted to explore the association between LAP and albuminuria in prediabetic individuals.

METHODS

We conducted a cross-sectional study and enrolled 26,529 participants with prediabetes over 40 years old with prediabetes from seven provinces in China. LAP was calculated from waist circumference and fasting triglycerides. Elevated albuminuria was defined by urinary albumin-creatinine ratio (uACR) ≥30 mg/g. Propensity score matching was applied to reduce bias, comparison between LAP and other traditional visceral obesity indices was performed and multiple logistic regression models were conducted to assess the association between LAP and albuminuria in the prediabetic population.

RESULTS

Individuals with uACR ≥30 mg/g were older and had higher BP, BMI, WC, TG, fasting insulin, glycohemoglobin and LAP, as well as lower eGFR and HDL level. Multiple logistic regression analysis showed elevated LAP was associated with increased odds of albuminuria (OR [95%CI] 1.09 [0.94, 1.27], OR [95%CI] 1.13 [0.97, 1.31], OR [95%CI] 1.42 [1.21, 1.67], for trend=0.018), and superior over waist-to-hip ratio or waist-to-height ratio. Stratification indicated that the prediabetic population with higher LAP level and characterized by female gender, middle age, being overweight, and rise in blood pressure were more likely to have increased uACR.

CONCLUSION

Elevated level of LAP was associated with increased albuminuria in the prediabetic population in China.

摘要

背景

脂质蓄积产物(LAP)作为内脏肥胖的一个有力标志物,是慢性肾脏病的独立危险因素。本研究旨在探讨糖尿病前期个体中LAP与蛋白尿之间的关联。

方法

我们进行了一项横断面研究,纳入了来自中国七个省份的26529名40岁以上的糖尿病前期参与者。LAP通过腰围和空腹甘油三酯计算得出。尿白蛋白排泄率(uACR)≥30mg/g定义为蛋白尿升高。采用倾向评分匹配以减少偏倚,对LAP与其他传统内脏肥胖指标进行比较,并进行多因素logistic回归模型分析以评估糖尿病前期人群中LAP与蛋白尿之间的关联。

结果

uACR≥30mg/g的个体年龄更大,血压、体重指数(BMI)、腰围(WC)、甘油三酯(TG)、空腹胰岛素、糖化血红蛋白和LAP更高,而估算肾小球滤过率(eGFR)和高密度脂蛋白(HDL)水平更低。多因素logistic回归分析显示,LAP升高与蛋白尿发生几率增加相关(OR[95%CI]为1.09[0.94,1.27],OR[95%CI]为1.13[0.97,1.31],OR[95%CI]为1.42[1.21,1.67],趋势P=0.018),且优于腰臀比或腰高比。分层分析表明,LAP水平较高、以女性、中年、超重和血压升高为特征的糖尿病前期人群更易出现uACR升高。

结论

在中国糖尿病前期人群中,LAP水平升高与蛋白尿增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0108/8168967/50239a5f0be8/DMSO-14-2415-g0001.jpg

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