Kebede Sewnet Adem, Tusa Biruk Shalmeno, Weldesenbet Adisu Birhanu, Tessema Zemenu Tadesse, Ayele Tadesse Awoke
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Collage of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.
J Nutr Metab. 2021 Aug 27;2021:6757916. doi: 10.1155/2021/6757916. eCollection 2021.
Although the rate of diabetic nephropathy which is the leading cause of end-stage renal disease (ESRD) continues to rise, there is limited information about the problem. This study aimed to assess the incidence and predictors of diabetic nephropathy among type 2 DM patients.
Institution-based retrospective follow-up study was conducted at UGCSH with 462 newly diagnosed type 2 DM patients from January 2001 to February 2016, and the data were collected by reviewing their records. The Schoenfeld residuals test was used to check proportional hazard assumption. The best model was selected by using Akaike information criteria (AIC). Hazard ratios (HR) with its respective 95% confidence interval were reported to show significance and strength of association.
The incidence rate of diabetic nephropathy was 14 (95% CI 10.8-17.7) cases per 10,000 patient-month observation. In addition, 63 (13.6%) DM patients developed diabetic nephropathy. The median time to develop diabetic nephropathy was 94.9 months with interquartile range (IOR) of (64.1-127.4) months. Type 2 DM patients who had coronary heart disease (AHR = 2.69, 95% CI 1.42-5.13) and anemia (AHR = 1.94, 95% CI 0.97-3.87) were at higher hazard for developing diabetic nephropathy. Besides this, having a long duration (>10 years) (AHR = 0.24, 95% CI 0.11-0.56) and being female (AHR = 0.44, 95% CI 0.26-0.73) was found to be protective against diabetic nephropathy.
The incidence of diabetic nephropathy among type 2 diabetes patients remains a significant public health problem. Duration of diabetes >10 years and female sex reduced the risk of diabetic nephropathy. Coronary heart disease and anemia increased the risk of diabetic nephropathy among type 2 DM patients. In light of these findings, early screening for diabetes complication is needed, and health professionals should give targeted intervention for type 2 DM patients with coronary heart disease comorbidity and anemia.
糖尿病肾病是终末期肾病（ESRD）的主要病因，其发病率持续上升，但关于该问题的信息有限。本研究旨在评估2型糖尿病患者中糖尿病肾病的发病率及预测因素。
在UGCSH开展了一项基于机构的回顾性随访研究，纳入2001年1月至2016年2月期间462例新诊断的2型糖尿病患者，通过查阅病历收集数据。采用Schoenfeld残差检验来检验比例风险假设。使用赤池信息准则（AIC）选择最佳模型。报告风险比（HR）及其相应的95%置信区间以显示关联的显著性和强度。
糖尿病肾病的发病率为每10000患者月观察期14例（95%CI 10.8 - 17.7）。此外，63例（13.6%）糖尿病患者发生了糖尿病肾病。发生糖尿病肾病的中位时间为94.9个月，四分位间距（IOR）为（64.1 - 127.4）个月。患有冠心病（AHR = 2.69，95%CI 1.42 - 5.13）和贫血（AHR = 1.94，95%CI 0.97 - 3.87）的2型糖尿病患者发生糖尿病肾病的风险更高。除此之外，糖尿病病程长（>10年）（AHR = 0.24，95%CI 0.11 - 0.56）和女性（AHR = 0.44，95%CI 0.26 - 0.73）被发现对糖尿病肾病有保护作用。
2型糖尿病患者中糖尿病肾病的发病率仍然是一个重大的公共卫生问题。糖尿病病程>10年和女性可降低糖尿病肾病风险。冠心病和贫血增加了2型糖尿病患者发生糖尿病肾病的风险。鉴于这些发现，需要对糖尿病并发症进行早期筛查，并且卫生专业人员应对合并冠心病和贫血的2型糖尿病患者进行有针对性的干预。
