Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.
Department of Endocrinology and Metabolism, Jingan Branch of Huashan Hospital, Shanghai, China.
Front Endocrinol (Lausanne). 2023 Jan 23;14:1052227. doi: 10.3389/fendo.2023.1052227. eCollection 2023.
To investigate the association between anemia and progression of diabetic kidney disease (DKD) in type 2 diabetes.
This was a retrospective study. A total of 2570 in-patients with type 2 diabetes hospitalized in Jinan branch of Huashan hospital from January 2013 to October 2017 were included, among whom 526 patients were hospitalized ≥ 2 times with a median follow-up period of 2.75 years. Annual rate of eGFR decline was calculated in patients with multiple admissions. A rate of eGFR decline exceeding -5 ml/min per 1.73 m per year was defined as rapid eGFR decline. The prevalence of DKD and clinical characteristics were compared between anemia and non-anemia patients. Correlation analysis was conducted between anemia and clinical parameters. Comparison of clinical features were carried out between rapid eGFR decline and slow eGFR decline groups. The risk factors for rapid DKD progression were analyzed using logistic regression analysis.
The prevalence of anemia was 28.2% among the 2570 diabetic patients, while in patients with DKD, the incidence of anemia was 37.8%. Patients with anemia had greater prevalence of DKD, higher levels of urinary albumin-to-creatinine ratio (UACR), serum creatinine, BUN, urine α1-MG, urine β2-MG, urine NAG/Cr, hsCRP, Cystatin C, homocysteine and lower eGFR, as compared to the patients without anemia. Anemia was correlated with age, UACR, eGFR, urinary NAG/Cr, hsCRP and diabetic retinopathy (DR). Logistic regression analysis of 526 patients with type 2 diabetes during the follow-up period showed that anemia was an independent risk factor for rapid eGFR decline.
Anemia is associated with worse renal function and is an independent risk factor for rapid eGFR decline in type 2 diabetes.
探讨 2 型糖尿病患者贫血与糖尿病肾脏疾病（DKD）进展的关系。
这是一项回顾性研究。纳入 2013 年 1 月至 2017 年 10 月华山医院济南分院住院的 2570 例 2 型糖尿病患者，其中 526 例患者多次住院，中位随访时间为 2.75 年。计算多次住院患者的 eGFR 年下降率。定义 eGFR 年下降率超过-5 ml/min/1.73 m 为 eGFR 快速下降。比较贫血和非贫血患者的 DKD 患病率和临床特征。分析贫血与临床参数的相关性。比较 eGFR 快速下降组和缓慢下降组的临床特征。采用 logistic 回归分析快速 DKD 进展的危险因素。
2570 例糖尿病患者中贫血的患病率为 28.2%，而在 DKD 患者中，贫血的发生率为 37.8%。与非贫血患者相比，贫血患者 DKD 患病率更高，尿白蛋白/肌酐比值（UACR）、血清肌酐、BUN、尿α1-MG、尿β2-MG、尿 NAG/Cr、hsCRP、胱抑素 C、同型半胱氨酸水平更高，eGFR 水平更低。贫血与年龄、UACR、eGFR、尿 NAG/Cr、hsCRP 和糖尿病视网膜病变（DR）有关。对随访期间的 526 例 2 型糖尿病患者进行 logistic 回归分析，结果显示贫血是 eGFR 快速下降的独立危险因素。
贫血与肾功能恶化有关，是 2 型糖尿病患者 eGFR 快速下降的独立危险因素。
