2型糖尿病女性患者的肾功能与动脉粥样硬化性心血管疾病、心血管疾病及其危险因素的10年风险的关联
Association of Kidney Function With 10-Year Risk of Atherosclerotic Cardiovascular Disease, Cardiovascular Disease and Its Risk Factors Among Women With Type 2 Diabetes Mellitus.
作者信息
Siddiqui Khalid, George Teena P, Mujammami Muhammad, Alfadda Assim A, Nawaz Shaik Sarfaraz, Rafiullah Mohamed
机构信息
Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Biochemistry, Faculty of Medicine, Kuwait University, Jabriya, 24923, Kuwait.
出版信息
Int J Womens Health. 2025 Feb 18;17:449-457. doi: 10.2147/IJWH.S485470. eCollection 2025.
PURPOSE
Women are at increased risk of developing kidney disease and cardiovascular disease (CVD) in their middle and older ages due to the impact of aging and hormonal variation associated with menopause transition. Women with diabetes are at greater risk of reduced kidney function. Reduced or even mildly reduced kidney function enhances the risk of developing atherosclerotic cardiovascular disease (ASCVD) among women with type 2 diabetes (T2D). Thus, the objective of this study is to determine the association of reduced or mildly reduced kidney function with an estimated 10-year risk of ASCVD, CVD, and cardiovascular risk factors among T2D women.
PATIENTS AND METHODS
This cross-sectional study is conducted among 393 T2D women, aged between 40-70 years, subdivided into three groups according to the level of estimated glomerular filtration rate (eGFR) (eGFR ≥90 mL/min/1.73m(normal), eGFR 60-89 mL/min/1.73m (mildly reduced) and eGFR <60 mL/min/1.73m (reduced)). Association of kidney function with an estimated 10-year risk of ASCVD as well as cardiovascular disease was determined.
RESULTS
Based on the current study findings, the presence of cardiovascular disease was found to be associated with mildly reduced (p=0.014) and reduced eGFR (p=0.004) among T2D participants with previous CVD. No association was found between mildly reduced or reduced eGFR with an estimated 10-year intermediate/high risk for ASCVD among T2D women without CVD. Even though the level of eGFR was significantly varied between pre and post-menopause T2D women, no association of kidney function with estimated 10-year ASCVD risk was observed. Among cardiovascular risk factors, the presence of hypertension was associated with mildly reduced/reduced eGFR among T2D women.
CONCLUSION
This study's findings highlight the graded, independent association of kidney function with cardiovascular disease among middle-aged and elderly T2D women with previous CVD, while no association with estimated 10-year risk for ASCVD among women without CVD.
目的
由于衰老以及与绝经过渡相关的激素变化的影响，中年及老年女性患肾病和心血管疾病（CVD）的风险增加。患有糖尿病的女性肾功能降低的风险更大。肾功能降低甚至轻度降低会增加2型糖尿病（T2D）女性患动脉粥样硬化性心血管疾病（ASCVD）的风险。因此，本研究的目的是确定肾功能降低或轻度降低与T2D女性估计的10年ASCVD、CVD风险及心血管危险因素之间的关联。
患者与方法
本横断面研究针对393名年龄在40至70岁之间的T2D女性进行，根据估计肾小球滤过率（eGFR）水平分为三组（eGFR≥90 mL/min/1.73m²（正常）、eGFR 60 - 89 mL/min/1.73m²（轻度降低）和eGFR<60 mL/min/1.73m²（降低））。确定肾功能与估计的10年ASCVD风险以及心血管疾病风险之间的关联。
结果
根据当前研究结果，在既往有CVD的T2D参与者中，发现心血管疾病的存在与轻度降低的eGFR（p = 0.014）和降低的eGFR（p = 0.004）相关。在无CVD的TED女性中，未发现轻度降低或降低的eGFR与估计的10年ASCVD中/高风险之间存在关联。尽管绝经前和绝经后T2D女性的eGFR水平存在显著差异，但未观察到肾功能与估计的10年ASCVD风险之间的关联。在心血管危险因素中，高血压的存在与T2D女性轻度降低/降低的eGFR相关。
结论
本研究结果突出了中年及老年既往有CVD的T2D女性中肾功能与心血管疾病之间存在分级、独立的关联，而在无CVD的女性中与估计的10年ASCVD风险无关联。
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