Muramatsu Taichi, Yamamuro Daisuke, Kushiyama Akifumi, Kikuchi Takako
Department of Pharmacotherapy, Meiji Pharmaceutical University, Kiyose City, Tokyo, Japan.
Division of Diabetes and Metabolism, The Institute for Medical Science, Asahi Life Foundation, Tokyo, Japan.
J Diabetes Investig. 2025 Feb;16(2):225-235. doi: 10.1111/jdi.14348. Epub 2024 Nov 12.
AIMS/INTRODUCTION: We investigated the association between the ankle reflex and the estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.
This was a single-center, retrospective, observational cohort study. A total of 1,387 patients who underwent an ankle reflex examination between January 2005 and December 2015 were included in the analysis for the primary outcome. The findings of the ankle reflex examination were classified into three groups: normal, decreased, or absent. The primary outcome was defined as the incidence of a 40% loss of eGFR from baseline. A survival time analysis using the Kaplan-Meier method and a regression analysis using a Cox proportional hazards model were conducted to evaluate the association between the ankle reflex test results and loss of eGFR.
The ankle reflex test results were as follows: normal, n = 678 (48.9%); decreased, n = 270 (19.5%); and absent, n = 439 (31.6%) patients. The median follow-up period was 5.6 years in the observational period. In the univariate regression analysis, decreased and absent ankle reflexes were significantly associated with loss of eGFR. Moreover, decreased ankle reflex (hazard ratio: 1.83, 95% confidence interval: 1.16-2.87) and absent ankle reflex (hazard ratio: 2.57, 95% confidence interval: 1.76-3.76) were independently associated with loss of eGFR after adjusting for prognostic risk factors.
Decreased and absent ankle reflexes are closely and independently associated with loss of eGFR in patients with type 2 diabetes.
目的/引言：我们研究了2型糖尿病患者的踝反射与估算肾小球滤过率（eGFR）之间的关联。
这是一项单中心、回顾性、观察性队列研究。共有1387例在2005年1月至2015年12月期间接受踝反射检查的患者纳入主要结局分析。踝反射检查结果分为三组：正常、减弱或消失。主要结局定义为eGFR自基线下降40%的发生率。采用Kaplan-Meier法进行生存时间分析，并使用Cox比例风险模型进行回归分析，以评估踝反射测试结果与eGFR下降之间的关联。
踝反射测试结果如下：正常678例（48.9%）；减弱270例（19.5%）；消失439例（31.6%）。观察期内的中位随访时间为5.6年。在单因素回归分析中，踝反射减弱和消失与eGFR下降显著相关。此外，在对预后危险因素进行校正后，踝反射减弱（风险比：1.83，95%置信区间：1.16 - 2.87）和踝反射消失（风险比：2.57，95%置信区间：1.76 - 3.76）与eGFR下降独立相关。
2型糖尿病患者踝反射减弱和消失与eGFR下降密切且独立相关。
