美国 2 型糖尿病患者血浆同型半胱氨酸与慢性肾脏病的关系：一项横断面研究。
Relationship between plasma homocysteine and chronic kidney disease in US patients with type 2 diabetes mellitus: a cross-sectional study.
机构信息
Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 23 Art Museum Back Street, Dongcheng District, Beijing, 100010, China.
Department of TCM Internal Medicine, Huguosi TCM Hospital, Affiliated with Beijing University of Chinese Medicine, Beijing, 100700, China.
出版信息
BMC Nephrol. 2022 Dec 31;23(1):419. doi: 10.1186/s12882-022-03045-6.
AIMS
This cross-sectional study aimed to investigate the association between plasma homocysteine (Hcy) and chronic kidney disease (CKD) in US patients with type 2 diabetes mellitus (T2DM).
METHODS
We used data from the 2003-2006 National Health and Nutritional Examination Surveys (NHANES). CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m and/or urinary albumin-creatine ratio ≥ 3 mg/mmol.
RESULTS
This study included 1018 patients with T2DM. The mean Hcy value was 10.2 ± 4.6 μmol/L. Among the patients, 417 (40.96%) had hyperhomocysteinemia (HHcy) and 480 (47.15%) had CKD. The Hcy level was higher in patients with CKD than in those without CKD. Compared to patients with normal Hcy, those with HHcy were older and had worse renal function. After full multivariate adjustment, HHcy was positively associated with the risk of CKD in US patients with T2DM (OR, 1.17; 95% CI, 1.11-1.22; P < 0.001), which for women was 1.15 (95% CI, 1.08 ~ 1.23; P < 0.001) and for men was 1.18 (95% CI, 1.1 ~ 1.27; P < 0.001).
CONCLUSIONS
HHcy was independently associated with CKD in patients with T2DM. Further prospective studies are warranted to investigate the effect of Hcy on CKD in patients with T2DM.
目的
本横断面研究旨在探讨美国 2 型糖尿病（T2DM）患者血浆同型半胱氨酸（Hcy）与慢性肾脏病（CKD）之间的关系。
方法
我们使用了 2003-2006 年全国健康和营养调查（NHANES）的数据。CKD 的定义为估计肾小球滤过率<60ml/min/1.73m2和/或尿白蛋白/肌酐比值≥3mg/mmol。
结果
本研究纳入了 1018 例 T2DM 患者。Hcy 的平均值为 10.2±4.6μmol/L。在这些患者中，417 例（40.96%）存在高同型半胱氨酸血症（HHcy），480 例（47.15%）患有 CKD。与无 CKD 的患者相比，CKD 患者的 Hcy 水平更高。与 Hcy 正常的患者相比，HHcy 患者年龄更大，肾功能更差。经过全多变量调整后，HHcy 与美国 T2DM 患者 CKD 的风险呈正相关（OR，1.17；95%CI，1.11-1.22；P<0.001），女性为 1.15（95%CI，1.08-1.23；P<0.001），男性为 1.18（95%CI，1.1-1.27；P<0.001）。
结论
HHcy 与 T2DM 患者的 CKD 独立相关。需要进一步的前瞻性研究来探讨 Hcy 对 T2DM 患者 CKD 的影响。
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