Department of Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Sci Rep. 2021 Jul 19;11(1):14705. doi: 10.1038/s41598-021-94099-3.
The association between rate of kidney function decline and age-of-onset or duration of diabetes has not been well investigated. We aimed to examine whether rates of estimated glomerular filtration rate (eGFR) decline differ by age-of-onset or duration in people with type 2 diabetes. Using the Action to Control Cardiovascular Risk in Diabetes study which included those with HbA1c ≥ 7.5% and who were at high risk of cardiovascular events,, rates of eGFR decline were calculated and were compared among groups defined by the known age-of-onset (0-39, 40-49, 50-59, 60-69 and > 70 years) and 5-year diabetes duration intervals. Changes in renal function were evaluated using median of 6 (interquartile range 3-10) eGFR measurements per person. eGFR decline was the slowest in those with known age-at-diagnosis of 50-59 years or those with duration of diabetes < 5 years. The rates of eGFR decline were significantly greater in those with known age-of-onset < 40 years or those with duration of diabetes > 20 years compared to those diagnosed at 50-59 or those with duration of diabetes < 5 years (- 1.98 vs - 1.61 mL/min/year; - 1.82 vs - 1.52 mL/min/year; respectively (p < 0.001). Those with youngest age-of-onset or longer duration of diabetes had more rapid declines in eGFR compared to those diagnosed at middle age or those with shorter duration of diabetes.
肾功能下降率与糖尿病发病年龄或病程的关系尚未得到充分研究。我们旨在探讨 2 型糖尿病患者的肾小球滤过率（eGFR）下降率是否因发病年龄或病程而异。本研究使用了 ACTION 研究的数据，该研究纳入了糖化血红蛋白（HbA1c）≥7.5%且有发生心血管事件高危因素的患者，计算了 eGFR 下降率，并根据已知的发病年龄（0-39 岁、40-49 岁、50-59 岁、60-69 岁和>70 岁）和 5 年糖尿病病程间隔对患者进行分组，并比较了不同分组之间的 eGFR 下降率。采用中位数法对 6 次（四分位距 3-10）eGFR 测量值进行肾功能变化评估。结果发现，发病年龄为 50-59 岁或病程<5 年的患者 eGFR 下降速度最慢。与发病年龄为 50-59 岁或病程<5 年的患者相比，已知发病年龄<40 岁或病程>20 年的患者的 eGFR 下降率明显更高（-1.98 与-1.61 mL/min/年；-1.82 与-1.52 mL/min/年；p<0.001）。与发病年龄较大或病程较短的患者相比，发病年龄最小或病程最长的患者 eGFR 下降速度更快。
