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血浆致动脉粥样硬化指数作为2型糖尿病慢性肾脏病和肝损伤的早期标志物

Atherogenic Index of Plasma as an Early Marker of Chronic Kidney Disease and Liver Injury in Type 2 Diabetes.

作者信息

Li Huifang, Miao Xia, Zhong Jiaoying, Zhu Zhaoming

机构信息

Department of Nephrology, Hebei Yiling Hospital, Shijiazhuang, Hebei, China.

出版信息

Clin Med Insights Endocrinol Diabetes. 2024 Jun 9;17:11795514241259741. doi: 10.1177/11795514241259741. eCollection 2024.

Abstract

BACKGROUND

Diabetic kidney disease (DKD) is the main cause of end-stage renal disease and has a high mortality rate. Currently, no effective treatments are available to reduce the progression of kidney damage associated with diabetes.

OBJECTIVES

To explore the influence and predictive value of the atherogenic index of plasma (AIP) on early chronic kidney disease and liver injury in patients with type 2 diabetes mellitus (T2DM).

METHODS

Medical records of 1057 hospitalized adult patients with T2DM between January 2021 and December 2022 were collected. The predictive value of AIP, renal function, and liver injury in patients with T2DM were analyzed using Pearson's correlation, multiple logistic regression, and receiver operating characteristic (ROC) curve analyses.

RESULTS

AIP was a sensitive indicator of early liver and kidney injury in patients with T2DM. Patients in the DKD group showed increased AIP that positively correlated with serum creatinine, uric acid, and β2-microglobulin levels. Increased AIP negatively correlated with estimated glomerular filtration rate (eGFR). AIP significantly correlated with alanine aminotransferase and aspartate aminotransferase levels and glutamyl transpeptidase-to-platelet ratio (GPR). An eGFR of 60-100 mL/min/1.73 m significantly increased the risk of DKD as the AIP increased. At lower GPR levels, the risk of DKD significantly increased with increasing AIP. However, no significant difference was found between the 2 groups when the GPR was >0.1407. The ROC curve analysis showed that AIP could predict early liver injury.

CONCLUSIONS

AIP is directly involved in early liver and kidney injury in T2DM and may be a sensitive indicator for early detection.

摘要

背景

糖尿病肾病(DKD)是终末期肾病的主要病因,死亡率很高。目前,尚无有效的治疗方法可减少与糖尿病相关的肾脏损害进展。

目的

探讨血浆致动脉粥样硬化指数(AIP)对2型糖尿病(T2DM)患者早期慢性肾脏疾病和肝损伤的影响及预测价值。

方法

收集2021年1月至2022年12月期间1057例住院成年T2DM患者的病历。采用Pearson相关性分析、多元逻辑回归分析和受试者工作特征(ROC)曲线分析,分析AIP、肾功能和肝损伤在T2DM患者中的预测价值。

结果

AIP是T2DM患者早期肝、肾损伤的敏感指标。DKD组患者的AIP升高,与血清肌酐、尿酸和β2-微球蛋白水平呈正相关。AIP升高与估算肾小球滤过率(eGFR)呈负相关。AIP与丙氨酸氨基转移酶、天冬氨酸氨基转移酶水平及谷氨酰转肽酶与血小板比值(GPR)显著相关。当eGFR为60-100 mL/min/1.73 m²时,随着AIP升高,DKD风险显著增加。在较低的GPR水平下,随着AIP升高,DKD风险显著增加。然而,当GPR>0.1407时,两组之间未发现显著差异。ROC曲线分析表明,AIP可预测早期肝损伤。

结论

AIP直接参与T2DM患者的早期肝、肾损伤,可能是早期检测的敏感指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f999/11163926/d5f9fbac38c4/10.1177_11795514241259741-fig1.jpg

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