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肝纤维化评分与糖尿病肾病的关系:一项住院患者的回顾性横断面研究。

Association Between Liver Fibrosis Score and Diabetic Kidney Disease: A Retrospective Cross-Sectional Study of Hospitalized Patients.

机构信息

Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.

Queen Mary School, Medical College, Nanchang University, Nanchang 330006, China.

出版信息

Exp Clin Endocrinol Diabetes. 2024 Jun;132(6):328-335. doi: 10.1055/a-2280-3742. Epub 2024 Apr 10.

Abstract

OBJECTIVES

To investigate the association between liver fibrosis score and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM).

METHODS

A total of 897 hospitalized patients with T2DM were included in this study. Each patient completed DKD screening. Logistic regression analysis was used to assess the predictive value of non-alcoholic fatty liver disease fibrosis score (NAFLD-FS) and fibrosis-4 (FIB-4) for the occurrence of DKD and risk for DKD progression, respectively.

RESULTS

The prevalence of DKD and risk for its progression significantly increased with increasing NAFLD-FS risk category. DKD prevalence also increased with increasing FIB-4 risk category. Multivariate logistic regression analysis showed that the "high-risk" NAFLD-FS had a significantly higher risk of DKD (odds ratio [OR]: 1.89, 95% confidence interval [CI]: 1.16-3.08) and risk for DKD progression (OR: 2.88, 95% CI: 1.23-6.78), and the "intermediate-risk" FIB-4 had a significantly higher risk of DKD (OR: 1.41, 95% CI: 1.00-1.98). Subgroup analysis showed that the association between NAFLD-FS and FIB-4 and DKD was significant in the female subgroup, whereas the association between the "high-risk" NAFLD-FS and risk for DKD progression was significant in the male subgroup.

CONCLUSIONS

NAFLD-FS and FIB-4 are strongly associated with DKD and risk for DKD progression in patients with T2DM. Additionally, sexual dimorphism exists in this association.

摘要

目的

探讨 2 型糖尿病(T2DM)患者肝纤维化评分与糖尿病肾脏疾病(DKD)的关系。

方法

共纳入 897 例住院 T2DM 患者,所有患者均完成 DKD 筛查。采用 logistic 回归分析评估非酒精性脂肪性肝病纤维化评分(NAFLD-FS)和纤维化-4 指数(FIB-4)对 DKD 发生及 DKD 进展风险的预测价值。

结果

随着 NAFLD-FS 风险类别增加,DKD 的患病率和进展风险显著增加。DKD 患病率也随着 FIB-4 风险类别增加而增加。多变量 logistic 回归分析显示,“高危”NAFLD-FS 发生 DKD 的风险显著增加(比值比 [OR]:1.89,95%置信区间 [CI]:1.16-3.08)和 DKD 进展风险(OR:2.88,95% CI:1.23-6.78),“中危”FIB-4 发生 DKD 的风险显著增加(OR:1.41,95% CI:1.00-1.98)。亚组分析显示,在女性亚组中,NAFLD-FS 和 FIB-4 与 DKD 相关,而在男性亚组中,“高危”NAFLD-FS 与 DKD 进展风险相关。

结论

NAFLD-FS 和 FIB-4 与 T2DM 患者 DKD 及 DKD 进展风险密切相关,且存在性别差异。

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