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2型糖尿病患者在感染新冠病毒后患新发高血压和慢性肾病的风险更高。

Patients With Type 2 Diabetes Are at Greater Risk of Developing New Hypertension and Chronic Kidney Disease Following COVID-19.

作者信息

Lu Justin Y, Mehrotra-Varma Shiv, Wang Stephen H, Boparai Montek Singh, Henry Sonya, Mehrotra-Varma Jai, Duong Tim Q

机构信息

Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA.

Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Diabetes Res. 2025 Jun 4;2025:8816198. doi: 10.1155/jdr/8816198. eCollection 2025.

Abstract

The purpose of this study was to test the hypothesis that COVID-19 status increases the incidence of new hypertension (HTN) and chronic kidney disease (CKD) in patients with Type 2 diabetes (T2D). This retrospective study consisted of 46,448 patients with T2D from the Montefiore Health System in the Bronx (3/01/2020-7/01/2023), of which 13,801 had a positive COVID-19 test on record. Contemporary controls included those hospitalized for other lower respiratory tract infections (LRTIs) ( = 1638) and nonhospitalized patients without COVID-19 or LRTI ( = 31009). Outcomes were assessed at follow-up (2 months to 3 years) relative to baseline. Adjusted hazards ratios (aHRs) with 95% confidence interval (CI) were computed. The cumulative incidences of HTN (22.32% vs. 9.13%, < 0.001) and CKD (6.20% vs. 2.03%, p <0.001) were significantly higher in nonhospitalized COVID-19 compared to non-COVID-19 patients, but not between patients hospitalized for COVID-19 and LRTI ( > 0.05). Nonhospitalized COVID-19 patients had higher risk of developing HTN compared to non-COVID patients during all follow-up (aHR 1.99, 95% CI [1.54, 2.57], < 0.001), but hospitalized COVID-19 patients had similar risk of developing HTN relative to patients hospitalized for LRTI (aHR 1.26 [0.70, 2.27], = 0.441). Nonhospitalized COVID-19 patients had higher risk of developing CKD compared to non-COVID patients during all follow-up (aHR 2.09 [1.69, 2.76], < 0.001), but hospitalized COVID-19 patients had similar risk of developing CKD relative to patients hospitalized for LRTI (aHR 0.96 [0.79, 1.36], = 0.131). T2D patients with COVID-19 were at higher risk of developing new disorders compared with COVID-19-negative controls and were at similar risk compared with those hospitalized for other LRTIs.

摘要

本研究的目的是检验以下假设

2型糖尿病(T2D)患者的新冠病毒病(COVID-19)状态会增加新发高血压(HTN)和慢性肾脏病(CKD)的发病率。这项回顾性研究纳入了来自布朗克斯蒙特菲奥里医疗系统的46448例T2D患者(2020年3月1日至2023年7月1日),其中13801例有新冠病毒检测呈阳性的记录。当代对照包括因其他下呼吸道感染(LRTIs)住院的患者(n = 1638)以及未感染COVID-19或LRTI的非住院患者(n = 31009)。在随访期(2个月至3年)相对于基线评估结局。计算了具有95%置信区间(CI)的调整后风险比(aHRs)。与未感染COVID-19的患者相比,非住院COVID-19患者的HTN累积发病率(22.32%对9.13%,p < 0.001)和CKD累积发病率(6.20%对2.03%,p < 0.001)显著更高,但COVID-19住院患者与LRTI住院患者之间无显著差异(p > 0.05)。在整个随访期内,与未感染COVID-19的患者相比,非住院COVID-19患者发生HTN的风险更高(aHR 1.99,95%CI [1.54, 2.57],p < 0.001),但与LRTI住院患者相比,COVID-19住院患者发生HTN的风险相似(aHR 1.26 [0.70, 2.27],p = 0.441)。在整个随访期内,与未感染COVID-19的患者相比,非住院COVID-19患者发生CKD的风险更高(aHR 2.09 [1.69, 2.76],p < 0.001),但与LRTI住院患者相比,COVID-19住院患者发生CKD的风险相似(aHR 0.96 [0.79, 1.36],p = 0.131)。与COVID-19阴性对照相比,患有COVID-19的T2D患者发生新疾病的风险更高,与因其他LRTIs住院的患者相比风险相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c76/12158568/6561283ead25/JDR2025-8816198.001.jpg

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