PDF(Pubmed)
Abstract：
BACKGROUND: Previous studies have shown that the red cell distribution width (RDW)/serum albumin ratio (RA) is an integrative and new inflammatory marker. RA is associated with clinical outcomes in a variety of diseases, but the clinical value of RDW/RA in the assessment of diabetic kidney disease (DKD) has not been elucidated. We examined the link between diabetic RA and DKD while controlling for a wide variety of possible confounders.
METHODS: Retrospective cohort analysis of the National Health and Nutrition Examination Survey (NHANES: 2009-2018) database from the Second Affiliated Hospital and Yuying Children\'s Hospital and the Wenzhou Medical University (WMU) database was conducted. Multivariate logistic regression analysis was used to assess the association between RA and DKD.
RESULTS: Overall, 4513 diabetic patients from the NHANES database (n = 2839) and the WMU (n = 1412) were included in this study; 974 patients were diagnosed with DKD in NHANES and 462 in WMU. In the NHANES cohort, diabetes mellitus (DM) patients with higher RA level had a higher risk of DKD (odds ratio = 1.461, 95% confidence interval: 1.250-1.707, p < 0.00001). After adjusting for confounders and propensity score-matched (PSM) analysis, both shown RA levels were independently linked to DKD (pAdjust = 0.00994, pPSM = 0.02889). Similar results were also observed in the WMU cohort (p < 0.00001).
CONCLUSIONS: The study observes that the RA was an independent predictor of DKD in DM patients. The RA, a biomarker that is cost-effective and easy-to-access, may have potential for risk stratification of DKD.
METHODS: Retrospective cohort analysis of the National Health and Nutrition Examination Survey (NHANES: 2009-2018) database from the Second Affiliated Hospital and Yuying Children\'s Hospital and the Wenzhou Medical University (WMU) database was conducted. Multivariate logistic regression analysis was used to assess the association between RA and DKD.
RESULTS: Overall, 4513 diabetic patients from the NHANES database (n = 2839) and the WMU (n = 1412) were included in this study; 974 patients were diagnosed with DKD in NHANES and 462 in WMU. In the NHANES cohort, diabetes mellitus (DM) patients with higher RA level had a higher risk of DKD (odds ratio = 1.461, 95% confidence interval: 1.250-1.707, p < 0.00001). After adjusting for confounders and propensity score-matched (PSM) analysis, both shown RA levels were independently linked to DKD (pAdjust = 0.00994, pPSM = 0.02889). Similar results were also observed in the WMU cohort (p < 0.00001).
CONCLUSIONS: The study observes that the RA was an independent predictor of DKD in DM patients. The RA, a biomarker that is cost-effective and easy-to-access, may have potential for risk stratification of DKD.
摘要：
背景：先前的研究表明，红细胞分布宽度（RDW）/血清白蛋白比率（RA）是一种整合的新型炎症标志物。RA与多种疾病的临床结果相关，但是RDW/RA在评估糖尿病肾病（DKD）中的临床价值尚未阐明。我们检查了糖尿病RA和DKD之间的联系，同时控制了各种可能的混淆因素。
方法：对第二附属医院、育英儿童医院和温州医科大学(WMU)数据库的全国健康与营养调查(NHANES:2009-2018)进行回顾性队列分析。采用多因素logistic回归分析评估RA与DKD的相关性。
结果：总体而言，来自NHANES数据库（n=2839）和WMU（n=1412）的4513名糖尿病患者被纳入本研究；NHANES中974名患者被诊断为DKD，WMU中462名。在NHANES队列中，RA水平较高的糖尿病(DM)患者发生DKD的风险较高(比值比=1.461,95%置信区间:1.250-1.707,p<0.00001).在调整混杂因素和倾向得分匹配(PSM)分析后，两者均显示RA水平与DKD独立相关(pAdjust=0.00994,pPSM=0.02889).在WMU队列中也观察到类似的结果(p<0.00001)。
结论：本研究观察到RA是DM患者DKD的独立预测因子。RA,一种具有成本效益且易于获取的生物标志物，可能有DKD风险分层的潜力。
方法：对第二附属医院、育英儿童医院和温州医科大学(WMU)数据库的全国健康与营养调查(NHANES:2009-2018)进行回顾性队列分析。采用多因素logistic回归分析评估RA与DKD的相关性。
结果：总体而言，来自NHANES数据库（n=2839）和WMU（n=1412）的4513名糖尿病患者被纳入本研究；NHANES中974名患者被诊断为DKD，WMU中462名。在NHANES队列中，RA水平较高的糖尿病(DM)患者发生DKD的风险较高(比值比=1.461,95%置信区间:1.250-1.707,p<0.00001).在调整混杂因素和倾向得分匹配(PSM)分析后，两者均显示RA水平与DKD独立相关(pAdjust=0.00994,pPSM=0.02889).在WMU队列中也观察到类似的结果(p<0.00001)。
结论：本研究观察到RA是DM患者DKD的独立预测因子。RA,一种具有成本效益且易于获取的生物标志物，可能有DKD风险分层的潜力。
