UNASSIGNED: A retrospective cohort of 815 subjects with DKD was followed from January 2010 to January 2023. A Cox proportional hazard regression model was utilized to explore the predictive role of hemoglobin in renal outcomes. Renal outcomes were defined as a composite endpoint, including a 50% decline in eGFR from baseline or progression to End-Stage Renal Disease (ESRD). To unveil any nonlinear relationship between hemoglobin and renal outcomes, Cox proportional hazard regression with cubic spline functions and smooth curve fitting was conducted. Additionally, subgroup analyses were performed to identify specific patient populations that might derive greater benefits from higher hemoglobin.
UNASSIGNED: Among the 815 DKD subjects, the mean age was 56.482 ± 9.924 years old, and 533 (65.4%) were male. The mean hemoglobin was 121.521±22.960 g/L. The median follow-up time was 21.103±18.335 months. A total of 182 (22.33%) individuals reached the renal composite endpoint during the study period. After adjusting for covariates, hemoglobin was found to exert a negative impact on the renal composite endpoint in patients with DKD (HR 0.975, 95% CI [0.966, 0.984]). A nonlinear relationship between hemoglobin and the renal composite endpoint was identified with an inflection point at 109 g/L. Subgroup analysis unveiled a more pronounced association between hemoglobin and renal prognosis in males.
UNASSIGNED: Hemoglobin emerges as a predictive indicator for the renal prognosis of diabetic kidney disease in China. This study reveals a negative and non-linear relationship between hemoglobin levels and the renal composite endpoint. A substantial association is noted when hemoglobin surpasses 109 g/L in relation to the renal composite endpoint.
■从2010年1月至2023年1月,对815名DKD受试者进行了回顾性队列研究。Cox比例风险回归模型用于探索血红蛋白在肾脏结局中的预测作用。肾脏结局被定义为复合终点,包括eGFR从基线或进展为终末期肾病(ESRD)下降50%。揭示血红蛋白和肾脏结局之间的任何非线性关系,用三次样条函数和平滑曲线拟合进行Cox比例风险回归。此外,我们进行了亚组分析,以确定可能从高血红蛋白中获得更大益处的特定患者人群.
■在815名DKD受试者中,平均年龄为56.482±9.924岁,男性533人(65.4%)。平均血红蛋白为121.521±22.960g/L中位随访时间为21.103±18.335个月。在研究期间,共有182名(22.33%)个体达到了肾脏复合终点。在调整协变量后,发现血红蛋白对DKD患者的肾脏复合终点有负面影响(HR0.975,95%CI[0.966,0.984]).确定血红蛋白与肾脏复合终点之间的非线性关系,拐点为109g/L。亚组分析揭示了男性血红蛋白与肾脏预后之间更明显的关联。
■在中国,血红蛋白成为糖尿病肾病患者肾脏预后的预测指标。这项研究揭示了血红蛋白水平与肾脏复合终点之间的负相关和非线性关系。当血红蛋白相对于肾脏复合终点超过109g/L时,注意到实质性关联。