PDF(Pubmed)
Abstract：
Effective treatment may prevent kidney complications, but women might be underprescribed. Novel, data-driven insights into prescriptions and their relationship with kidney health in women with type 1 diabetes may help to optimize treatment. We identified six medication profiles in 1164 women from the FinnDiane Study with normal albumin excretion rate based on clusters of their baseline prescription data using a self-organizing map. Future rapid kidney function decline was defined as an annual estimated glomerular filtration rate (eGFR) loss > 3 ml/min/1.73 m2 after baseline. Two profiles were associated with future decline: Profile ARB with the highest proportion of angiotensin receptor blockers (odds ratio [OR] 2.75, P = 0.02) and highly medicated women in profile HighMed (OR 2.55, P = 0.03). Compared with profile LowMed (low purchases of all), profile HighMed had worse clinical characteristics, whereas in profile ARB only systolic blood pressure was elevated. Importantly, the younger women in profile ARB with fewer kidney protective treatments developed a rapid decline despite otherwise similar baseline characteristics to profile ACE & Lipids (the highest proportions of ACE inhibitors and lipid-modifying agents) without a future rapid decline. In conclusion, medication profiles identified different future eGFR trajectories in women with type 1 diabetes revealing potential treatment gaps for younger women.
摘要：
有效的治疗可以预防肾脏并发症，但是女性可能被低估了。小说,以数据为导向的1型糖尿病女性处方及其与肾脏健康关系的研究可能有助于优化治疗.我们使用自组织图，根据基线处方数据的聚类，从FinnDiane研究中确定了1164名具有正常白蛋白排泄率的女性的6种药物分布。未来肾功能快速下降定义为基线后每年估计的肾小球滤过率（eGFR）损失>3ml/min/1.73m2。两种情况与未来的下降相关：ARB的比例最高的血管紧张素受体阻滞剂（比值比[OR]2.75，P=0.02）和高Med中药物治疗的女性（OR2.55，P=0.03）。与配置文件LowMed(低购买所有)相比，简介HighMed的临床特征较差，而在ARB中，只有收缩压升高。重要的是,尽管基线特征与ACE和脂质(ACE抑制剂和脂质调节剂的比例最高)相似,但肾脏保护性治疗较少的ARB中的年轻女性出现了快速下降.总之,用药概况确定了1型糖尿病女性未来不同的eGFR轨迹,揭示了年轻女性的潜在治疗差距.
