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残余胆固醇对2型糖尿病患者不良肾脏结局的预后价值。

The prognostic value of remnant cholesterol to adverse renal outcomes in patients with type 2 diabetes.

作者信息

Yu Pan, Yuan Qiongjing, Huang Ling, Tao Lijian, Peng Zhangzhe, Pu Jiaxi

机构信息

Department of Nephrology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, Hunan Province, China.

Hunan Key Lab of Organ Fibrosis, Changsha, China.

出版信息

Diabetol Metab Syndr. 2025 Feb 12;17(1):52. doi: 10.1186/s13098-025-01617-8.

Abstract

BACKGROUND

Type 2 diabetes (T2DM) is known to have detrimental effects on renal health. Our study aimed to investigate the relationship between remnant cholesterol (remnant-C) and adverse renal outcomes in patients with T2DM.

METHODS

We utilized data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, which included 10,196 participants with T2DM to investigate the relationship between remnant-C and adverse renal outcomes by performing Kaplan-Meier survival analysis, Cox proportional regression and Restricted cubic spline (RCS) analysis. Finally, several sensitivity analyses were conducted to assess the robustness of our findings.

RESULTS

Over a 7-year follow-up period, 2039 patients (23.2%) developed albuminuria, 5824 patients (57.1%) experienced worsening renal function, and 280 patients (2.7%) progressed to renal failure. After adjusting for multiple confounding factors, we found that remnant-C was significantly associated with the development of albuminuria (P = 0.007) and worsening renal function (P = 0.002). However, there was no discernible connection between remnant-C and renal faiure (P = 0.621). In sensitivity analyses, the association between remnant-C and the risk of adverse renal outcomes remained robust.

CONCLUSION

Our findings highlight the association between remnant-C and the risk of adverse renal outcomes in patients with T2DM. This easily calculable index can provide valuable information to physicians for predicting the risk of adverse renal outcomes in patients with T2DM.

摘要

背景

已知2型糖尿病(T2DM)对肾脏健康有不良影响。我们的研究旨在调查残余胆固醇(remnant-C)与T2DM患者不良肾脏结局之间的关系。

方法

我们利用糖尿病心血管风险控制行动(ACCORD)试验的数据,该试验纳入了10196名T2DM参与者,通过进行Kaplan-Meier生存分析、Cox比例回归和限制性立方样条(RCS)分析来研究remnant-C与不良肾脏结局之间的关系。最后,进行了多项敏感性分析以评估我们研究结果的稳健性。

结果

在7年的随访期内,2039名患者(23.2%)出现蛋白尿,5824名患者(57.1%)肾功能恶化,280名患者(2.7%)进展为肾衰竭。在调整了多个混杂因素后,我们发现remnant-C与蛋白尿的发生(P = 0.007)和肾功能恶化(P = 0.002)显著相关。然而,remnant-C与肾衰竭之间没有明显关联(P = 0.621)。在敏感性分析中,remnant-C与不良肾脏结局风险之间的关联仍然稳健。

结论

我们的研究结果突出了remnant-C与T2DM患者不良肾脏结局风险之间的关联。这个易于计算的指标可以为医生提供有价值的信息,用于预测T2DM患者不良肾脏结局的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/732d/11823253/5d447d66b8a0/13098_2025_1617_Fig1_HTML.jpg

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本文引用的文献

1
Association between remnant cholesterol and chronic kidney disease in Chinese hypertensive patients.
Front Endocrinol (Lausanne). 2023 Jun 21;14:1189574. doi: 10.3389/fendo.2023.1189574. eCollection 2023.
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Association of remnant cholesterol with chronic kidney disease in middle-aged and elderly Chinese: a population-based study.
Acta Diabetol. 2021 Dec;58(12):1615-1625. doi: 10.1007/s00592-021-01765-z. Epub 2021 Jun 28.
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Nat Rev Nephrol. 2021 Aug;17(8):528-542. doi: 10.1038/s41581-021-00423-5. Epub 2021 May 10.
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Remnant cholesterol predicts progression of diabetic nephropathy and retinopathy in type 1 diabetes.
J Intern Med. 2021 Sep;290(3):632-645. doi: 10.1111/joim.13298. Epub 2021 May 8.
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Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease.
J Am Coll Cardiol. 2020 Dec 8;76(23):2712-2724. doi: 10.1016/j.jacc.2020.10.008.

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