Lin Zishan, Wang Wenfeng, Xie Shidong, Jiang Bingjing, Zhang Xiaohong, Xu Yanfang
Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
Research Center for Metabolic Chronic Kidney Disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
BMC Public Health. 2025 Sep 24;25(1):3065. doi: 10.1186/s12889-025-24272-0.
Diabetic kidney disease (DKD) is a severe and prevalent complication of diabetes. Social contexts have been increasingly recognized as critical factors in the escalation and ongoing management of chronic diseases, including DKD. This study aimed to evaluate the connection between social risk profile (SRP) and DKD in United States. METHODS: Data were sourced from the National Health and Nutrition Examination Survey (1999-2018). DKD was defined as the coexistence of diabetes and chronic kidney disease (CKD). SRP scores, based on the number of positive measures, were categorized into four quartiles: low (0-2), lower-middle (3-4), upper-middle (5-6), and high (7-8). The associations of SRP with the prevalence and mortality of DKD were assessed. RESULTS: A total of 6,464 participants were included in the study, among them, 2,668 had DKD, and 1,153 died during a mean follow-up of 143 months. SRP scores were associated with the prevalence and mortality of DKD. Compared with high SRP scores, low SRP levels were related with a higher risk of DKD (OR, 1.86; 95% CI, 1.54 to 2.26, P < 0.0001). Higher SRP scores were associated with lower risks of mortality, including all-cause (HR, 0.84; 95% CI, 0.81-0.88; P < 0.0001), cardiovascular disease (HR, 0.85; 95% CI, 0.80-0.91; P < 0.0001), and diabetes-related mortality (HR, 0.86; 95% CI, 0.76-0.96; P = 0.009). CONCLUSION: Lower SRP scores showed a connection to higher DKD prevalence and worse outcomes, highlighting the potential importance of social risk screening and targeted interventions.
糖尿病肾病（DKD）是糖尿病一种严重且常见的并发症。社会环境日益被视为包括DKD在内的慢性疾病病情加重及持续管理的关键因素。本研究旨在评估美国社会风险概况（SRP）与DKD之间的关联。方法：数据来源于国家健康与营养检查调查（1999 - 2018年）。DKD被定义为糖尿病与慢性肾脏病（CKD）并存。基于阳性指标数量的SRP得分被分为四个四分位数：低（0 - 2）、中低（3 - 4）、中高（5 - 6）和高（7 - 8）。评估了SRP与DKD患病率及死亡率之间的关联。结果：共有6464名参与者纳入研究，其中2668人患有DKD，在平均143个月的随访期间，1153人死亡。SRP得分与DKD的患病率及死亡率相关。与高SRP得分相比，低SRP水平与更高的DKD风险相关（比值比，1.86；95%置信区间，1.54至2.26，P < 0.0001）。较高的SRP得分与较低的死亡风险相关，包括全因死亡（风险比，0.84；95%置信区间，0.81 - 0.88；P < 0.0001）、心血管疾病（风险比，0.85；95%置信区间，0.80 - 0.91；P < 0.0001）以及糖尿病相关死亡率（风险比，0.86；95%置信区间，0.76 - 0.96；P = 0.009）。结论：较低的SRP得分与较高的DKD患病率及更差的结局相关，凸显了社会风险筛查和针对性干预的潜在重要性。
