代谢综合征即使在没有糖尿病的情况下，也会使 CKD 1-4 期患者的肾脏结局发生高风险：ICKD 数据库。
High risk of renal outcome of metabolic syndrome independent of diabetes in patients with CKD stage 1-4: The ICKD database.
机构信息
Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
出版信息
Diabetes Metab Res Rev. 2023 May;39(4):e3618. doi: 10.1002/dmrr.3618. Epub 2023 Feb 20.
AIMS
To investigate whether metabolic syndrome (MetS) could predict renal outcome in patients with established chronic kidney disease (CKD).
MATERIALS AND METHODS
We enroled 2500 patients with CKD stage 1-4 from the Integrated CKD care programme, Kaohsiung for delaying Dialysis (ICKD) prospective observational study. 66.9% and 49.2% patients had MetS and diabetes (DM), respectively. We accessed three clinical outcomes, including all-cause mortality, RRT, and 50% decline in estimated glomerular filtration rate events.
RESULTS
The MetS score was positively associated with proteinuria, inflammation, and nutrition markers. In fully adjusted Cox regression, the hazard ratio (HR) (95% confidence interval) of MetS for composite renal outcome (renal replacement therapy, and 50% decline of renal function) in the DM and non-DM subgroups was 1.56 (1.15-2.12) and 1.31 (1.02-1.70), respectively, while that for all-cause mortality was 1.00 (0.71-1.40) and 1.27 (0.92-1.74). Blood pressure is the most important component of MetS for renal outcomes. In the 2 by 2 matrix, compared with the non-DM/non-MetS group, the DM/MetS group (HR: 1.62 (1.31-2.02)) and the non-DM/MetS group (HR: 1.33 (1.05-1.69)) had higher risks for composite renal outcome, whereas the DM/MetS group had higher risk for all-cause mortality (HR: 1.43 (1.09-1.88)).
CONCLUSIONS
MetS could predict renal outcome in patients with CKD stage 1-4 independent of DM.
目的
研究代谢综合征（MetS）是否可预测已确诊慢性肾脏病（CKD）患者的肾脏结局。
材料和方法
我们从高雄整合慢性肾脏病照护计划延缓透析（ICKD）前瞻性观察性研究中纳入了 2500 名 CKD 1-4 期患者。66.9%和 49.2%的患者分别患有 MetS 和糖尿病（DM）。我们评估了 3 种临床结局，包括全因死亡率、肾脏替代治疗（RRT）和估计肾小球滤过率下降 50%事件。
结果
MetS 评分与蛋白尿、炎症和营养标志物呈正相关。在完全调整的 Cox 回归中，DM 和非 DM 亚组中 MetS 对复合肾脏结局（RRT 和肾功能下降 50%）的危险比（HR）（95%置信区间）分别为 1.56（1.15-2.12）和 1.31（1.02-1.70），而全因死亡率的 HR 为 1.00（0.71-1.40）和 1.27（0.92-1.74）。血压是 MetS 对肾脏结局最重要的组成部分。在 2×2 矩阵中，与非 DM/非 MetS 组相比，DM/MetS 组（HR：1.62（1.31-2.02））和非 DM/MetS 组（HR：1.33（1.05-1.69））发生复合肾脏结局的风险更高，而 DM/MetS 组全因死亡率的风险更高（HR：1.43（1.09-1.88））。
结论
MetS 可预测 CKD 1-4 期患者的肾脏结局，独立于 DM。
Zotero 插件