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欧洲ePREDICE试验中糖尿病前期患者肾脏受累的患病率及相关因素。

Prevalence and factors linked to renal involvement in prediabetes patients across Europe in the ePREDICE trial.

作者信息

Mas-Fontao Sebastián, Civantos Esther, Boukichou Nisa, Moreno Juan A, Tuomilehto Jaakko, Gabriel Rafael, Egido Jesús

机构信息

Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain.

Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.

出版信息

Sci Rep. 2024 Dec 5;14(1):30336. doi: 10.1038/s41598-024-79842-w.

Abstract

This sub-analysis of the ePREDICE trial, investigated the prevalence and determinants of renal complications, specifically glomerular hyperfiltration, albuminuria, and reduced kidney function, in individuals with prediabetes (PD). The cohort consisted of 967 participants from diverse backgrounds across seven countries. The kidney function was evaluated using the MDRD-4 equation, and the influence of various clinical and demographic factors on renal involvement was assessed by multivariable regression models. Additionally, insulinogenic and disposition indices were examined. Overall, the prevalence of renal abnormalities in this PD cohort was 9.2% (n = 89). Key findings included the detection of hyperfiltration in 20 (2%) individuals, albuminuria in 45 (4.7%), and CKD stage G3a in 29 (3%). Hyperfiltration was inversely correlated with age and height, while albuminuria showed a significant direct association with the disposition index (DI). Age and waist circumference were significantly and directly associated with estimated glomerular filtration rate (eGFR). The ePREDICE study highlights critical factors that affect renal involvement in PD individuals, revealing complex interactions among various parameters. These findings further emphasize the necessity for the search of early kidney abnormalities in people with PD especially in those in older age groups and with a large waist circumference.

摘要

这项对ePREDICE试验的亚分析,调查了糖尿病前期(PD)个体中肾脏并发症的患病率及其决定因素,特别是肾小球高滤过、蛋白尿和肾功能减退。该队列由来自七个国家、背景各异的967名参与者组成。使用MDRD-4方程评估肾功能,并通过多变量回归模型评估各种临床和人口统计学因素对肾脏受累的影响。此外,还检查了胰岛素生成指数和处置指数。总体而言,该PD队列中肾脏异常的患病率为9.2%(n = 89)。主要发现包括20名(2%)个体检测到高滤过,45名(4.7%)个体检测到蛋白尿,29名(3%)个体处于慢性肾脏病G3a期。高滤过与年龄和身高呈负相关,而蛋白尿与处置指数(DI)呈显著正相关。年龄和腰围与估计肾小球滤过率(eGFR)呈显著正相关。ePREDICE研究突出了影响PD个体肾脏受累的关键因素,揭示了各种参数之间复杂的相互作用。这些发现进一步强调了在PD患者中,尤其是在老年组和腰围较大的患者中,寻找早期肾脏异常的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d20/11621331/fa762a2abbf8/41598_2024_79842_Fig1_HTML.jpg

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