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尿肌酐与糖尿病肾病之间的非线性关系:对临床实践的启示。

Non-linear relationship between urinary creatinine and diabetic kidney disease: implications for clinical practice.

作者信息

Cao Huihong, Song Li, Wang Xiaojun, Guan Haochen

机构信息

Department of Endocrinology of Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China.

Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, China.

出版信息

BMC Nephrol. 2025 Jan 24;26(1):40. doi: 10.1186/s12882-025-03971-1.

Abstract

OBJECTIVE

This study aims to investigate the relationship between urinary creatinine (UCr) and the risk and severity of Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM). The goal is to establish UCr as a potential biomarker for early DKD detection and severity assessment.

METHODS

A retrospective cross-sectional analysis was conducted using medical records of T2DM patients. Patients were classified into groups with and without DKD, and relevant clinical data, including demographic, blood, and urine parameters, were collected. Logistic regression and receiver operating characteristic (ROC) curve analysis evaluated the association between UCr levels and DKD. Curve fitting and threshold effect model were used to further evaluate the relationship between UCr and the incidence and severity of DKD.

RESULTS

A total of 302 T2DM patients were analyzed, with 137 diagnosed with DKD. Significant differences in clinical parameters were observed between the DKD and non-DKD groups, particularly in UCr, urine albumin levels, and eGFR. UCr levels demonstrated a strong association with DKD. Moreover, a non-linear relationship was identified, with specific inflection points indicating different correlation patterns of UCr with DKD occurrence and progression.

CONCLUSION

The findings of this study highlight the potential of UCr as a valuable biomarker for early detection and assessment of DKD in T2DM patients. Incorporating UCr measurements into routine clinical practice could enhance early identification of patients at risk for kidney complications, leading to timely intervention and improved patient outcomes.

摘要

目的

本研究旨在探讨2型糖尿病(T2DM)患者尿肌酐(UCr)与糖尿病肾病(DKD)风险及严重程度之间的关系。目标是将UCr确立为早期DKD检测和严重程度评估的潜在生物标志物。

方法

采用T2DM患者的病历进行回顾性横断面分析。将患者分为患有和未患有DKD的组,并收集相关临床数据,包括人口统计学、血液和尿液参数。采用逻辑回归和受试者工作特征(ROC)曲线分析评估UCr水平与DKD之间的关联。使用曲线拟合和阈值效应模型进一步评估UCr与DKD发病率和严重程度之间的关系。

结果

共分析了302例T2DM患者,其中137例被诊断为DKD。DKD组和非DKD组之间在临床参数上存在显著差异,尤其是在UCr、尿白蛋白水平和估算肾小球滤过率(eGFR)方面。UCr水平与DKD密切相关。此外,还发现了一种非线性关系,特定的拐点表明UCr与DKD发生和进展的不同相关模式。

结论

本研究结果突出了UCr作为T2DM患者早期检测和评估DKD的有价值生物标志物的潜力。将UCr测量纳入常规临床实践可增强对有肾脏并发症风险患者的早期识别,从而实现及时干预并改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82dc/11762113/9b0af2602154/12882_2025_3971_Fig2_HTML.jpg

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