Department of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, People's Republic of China.
Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, 330006, People's Republic of China.
BMC Public Health. 2024 Nov 18;24(1):3192. doi: 10.1186/s12889-024-20715-2.
We evaluated the interaction of urinary protein-to-creatinine ratio (UPCR) with diabetes on the risk of cardiovascular events in a cohort study.
The study population consisted of 639 participants with chronic kidney disease (CKD) stages 2-5, enrolled between 2010 and 2011 in Japan. Cox proportional hazards models were used to evaluate the independent and combined effects of the UPCR and diabetes on cardiovascular events.
During a median follow-up of 3 years, 59 participants developed cardiovascular events during follow-up. A notably higher risk of cardiovascular events was found in participants with proteinuria [hazards ratio (HR): 2.16, 95% confidence interval (95% CI): 1.17-3.97] compared to those without proteinuria at UPCR levels. In addition, the participants with diabetes had a higher risk of cardiovascular events (HR: 2.53, 95% CI: 1.49-4.30) than those without diabetes. Moreover, an interaction was found between UPCR and diabetes on cardiovascular events (P for interaction = 0.04). Participants with both proteinuria (UPCR ≥ 0.5 g/gCr) and diabetes had a 4.09 times higher risk of cardiovascular events (HR: 4.09, 95% CI: 1.97-8.47) compared with those without proteinuria (UPCR < 0.5 g/gCr) and diabetes.
In summary, among participants with CKD stages 2-5, proteinuria and diabetes were found to independently and jointly affect the risk of cardiovascular events. Participants with proteinuria and diabetes had the highest risk of cardiovascular events compared with other groups.
我们在一项队列研究中评估了尿蛋白与肌酐比值（UPCR）与糖尿病之间的相互作用对心血管事件风险的影响。
研究人群包括 2010 年至 2011 年在日本登记的 639 名慢性肾脏病（CKD）2-5 期患者。使用 Cox 比例风险模型评估 UPCR 和糖尿病对心血管事件的独立和联合作用。
在中位随访 3 年期间，59 名参与者在随访期间发生心血管事件。与 UPCR 水平无蛋白尿的参与者相比，蛋白尿患者发生心血管事件的风险明显更高[风险比（HR）：2.16，95%置信区间（95%CI）：1.17-3.97]。此外，患有糖尿病的参与者发生心血管事件的风险高于无糖尿病的参与者（HR：2.53，95%CI：1.49-4.30）。此外，还发现 UPCR 和糖尿病对心血管事件存在交互作用（P 交互=0.04）。同时患有蛋白尿（UPCR≥0.5 g/gCr）和糖尿病的参与者发生心血管事件的风险比无蛋白尿（UPCR<0.5 g/gCr）和无糖尿病的参与者高 4.09 倍（HR：4.09，95%CI：1.97-8.47）。
综上所述，在 CKD 2-5 期患者中，蛋白尿和糖尿病独立且共同影响心血管事件的风险。与其他组相比，同时患有蛋白尿和糖尿病的参与者发生心血管事件的风险最高。
