Yoo Jee Hee, Kim Ji Yoon, Kim Jae Hyeon
Division of Endocrinology and Metabolism, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Diabetes Technol Ther. 2023 Oct;25(10):726-735. doi: 10.1089/dia.2023.0165. Epub 2023 Aug 29.
The glycemia risk index (GRI) is a new composite metric derived from continuous glucose monitoring (CGM) data to assess the quality of glycemia. This study investigates the association between the GRI and albuminuria. Professional CGM and urinary albumin-to-creatinine ratio (UACR) data from 866 individuals with type 2 diabetes were retrospectively reviewed. Albuminuria and macroalbuminuria were defined as one or more UACR measurements ≥30 and ≥300 mg/g, respectively. The overall prevalence of albuminuria and macroalbuminuria was 36.6% and 13.9%, respectively. Participants with a higher UACR had a significantly higher hyperglycemia component and GRI score than those with a lower UACR (all < 0.001), although the hypoglycemia component did not differ among the groups. Multiple logistic regression analyses that adjusted for various factors affecting albuminuria revealed that the odds ratio (OR) of albuminuria was 1.13 (95% confidence interval [CI]: 1.02-1.27, = 0.039) per increase in the GRI zone. The results were similar for the risk of macroalbuminuria (OR: 1.42 [95% CI: 1.20-1.69], < 0.001), and that association remained after adjusting for glycated hemoglobin (OR: 1.31 [95% CI: 1.10-1.58], = 0.004). GRI is strongly associated with albuminuria, especially macroalbuminuria, in type 2 diabetes.
血糖风险指数（GRI）是一种从连续血糖监测（CGM）数据中得出的新综合指标，用于评估血糖质量。本研究调查了GRI与蛋白尿之间的关联。对866例2型糖尿病患者的专业CGM和尿白蛋白与肌酐比值（UACR）数据进行了回顾性分析。蛋白尿和大量蛋白尿分别定义为一次或多次UACR测量值≥30和≥300mg/g。蛋白尿和大量蛋白尿的总体患病率分别为36.6%和13.9%。UACR较高的参与者的高血糖成分和GRI评分显著高于UACR较低的参与者（均<0.001），尽管低血糖成分在各组之间没有差异。对影响蛋白尿的各种因素进行校正的多因素logistic回归分析显示，GRI每增加一个区域，蛋白尿的比值比（OR）为1.13（95%置信区间[CI]：1.02-1.27，P=0.039）。大量蛋白尿风险的结果相似（OR：1.42[95%CI：1.20-1.69]，P<0.001），在调整糖化血红蛋白后该关联仍然存在（OR：1.31[95%CI：1.10-1.58]，P=0.004）。在2型糖尿病中，GRI与蛋白尿尤其是大量蛋白尿密切相关。
