Vich-Pérez Pilar, Taulero-Escalera Belén, Regueiro-Toribio Paula, Cárdenas-de Miguel Almudena, San Román Muñoz Rebeca, Salinero-Fort Miguel A
Hospital La Paz Institute for Health Research (IdiPAZ), 28029 Madrid, Spain.
Los Alpes Health Centre, 28022 Madrid, Spain.
J Clin Med. 2025 Apr 16;14(8):2732. doi: 10.3390/jcm14082732.
The current study aims to estimate the frequency of abnormal renal status (ARS, defined as chronic kidney disease (CKD) diagnosis in electronic medical records or current albuminuria) in people with newly diagnosed diabetes mellitus (DM), to determine the associated risk factors, and to evaluate the level of compliance with good clinical practice recommendations. Cross-sectional study with 1030 adults diagnosed with DM in the last 4 years. Anthropometric, clinical, analytical, and lifestyle variables were collected. Multivariate analyses were performed to determine the factors associated with ARS. Hypercholesterolaemia, metabolic syndrome, hypertension, obesity, hypertriglyceridaemia, and cardiovascular disease (CVD) were the most prevalent comorbidities. ARS was present in 11.5% of patients. The variables associated with ARS were male sex (OR: 1.78; 95% CI, 1.16-2.75), age ≥70 years (OR: 2.96; 95% CI: 1.92-4.56), hypertension (OR: 1.59; 95% CI: 1.03-2.44), CVD (OR: 1.73; 95% CI: 1.03-2.90), and hemoglobin A1c (HbA1c) ≥8% (OR: 2.26; 95% CI, 1.19-4.27). Among patients with hypertension and albuminuria, 80% received angiotensin-converting enzyme inhibitors (ACE inhibitor) or an angiotensin receptor blocker (ARB), compared to 60% of those with albuminuria without hypertension. The 42.4% patients with ARS were treated with sodium-glucose cotransporter type 2 inhibitors (SGLT2i) and 72% with statins, but only 31.5% achieved the target low density lipoproteins cholesterol (LDLc) < 70 mg/dL. ARS in newly diagnosed patients with DM is less common than described in the literature, but risk factors for its development are highly prevalent. Adherence to good clinical practice recommendations was poor, especially in LDL cholesterol targets and the use of SGLT2i.
本研究旨在评估新诊断糖尿病患者中异常肾脏状态（ARS，定义为电子病历中慢性肾脏病（CKD）诊断或当前白蛋白尿）的发生率，确定相关危险因素，并评估遵循良好临床实践建议的程度。对过去4年中诊断为糖尿病的1030名成年人进行横断面研究。收集人体测量、临床、分析和生活方式变量。进行多变量分析以确定与ARS相关的因素。高胆固醇血症、代谢综合征、高血压、肥胖、高甘油三酯血症和心血管疾病（CVD）是最常见的合并症。11.5%的患者存在ARS。与ARS相关的变量包括男性（比值比：1.78；95%置信区间，1.16 - 2.75）、年龄≥70岁（比值比：2.96；95%置信区间：1.92 - 4.56）、高血压（比值比：1.59；95%置信区间：1.03 - 2.44）、CVD（比值比：1.73；95%置信区间：1.03 - 2.90）以及糖化血红蛋白（HbA1c）≥8%（比值比：2.26；95%置信区间，1.19 - 4.27）。在高血压和白蛋白尿患者中，80%接受了血管紧张素转换酶抑制剂（ACE抑制剂）或血管紧张素受体阻滞剂（ARB），而无高血压的白蛋白尿患者中这一比例为60%。42.4%的ARS患者接受了钠 - 葡萄糖协同转运蛋白2抑制剂（SGLT2i）治疗，72%接受了他汀类药物治疗，但只有31.5%的患者达到了低密度脂蛋白胆固醇（LDLc）<70mg/dL的目标。新诊断糖尿病患者中的ARS比文献报道的少见，但其发生的危险因素非常普遍。对良好临床实践建议的遵循情况较差，尤其是在LDL胆固醇目标和SGLT2i的使用方面。
