PDF(Pubmed)
Abstract：
Type 2 diabetes mellitus (T2DM) is a risk factor for patients with impaired renal function. The onset of T2DM-induced diabetic kidney disease (DKD) is frequently sub-clinical, potentially culminating in end-stage renal disease. In the current study the factors influencing DKD in elderly patients diagnosed with T2DM were determined. A retrospective cohort study was conducted involving patients ≥60 years of age with T2DM from June 2019 to December 2022. The Cockcroft-Gault formula was used to estimate the glomerular filtration rate. The clinical information and biochemical indicators of patients with an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m2 were collected. Patients were grouped based on a 3-year eGFR decline < 15% and ≥ 15%. The differences between the two groups were compared and the factors influencing the 3-year eGFR decline ≥ 15% were analyzed. A total of 242 patients were included, including 154 in the group with a 3-year eGFR decline < 15% and 88 in the group with a three-year eGFR decline ≥ 15%. Univariate logistic regression analysis showed that smoking cigarettes, and triglycerides (TG) and high-density lipoprotein levels were related to a 3-year eGFR decline ≥ 15% (P = .039, P < .001, and P = .011, respectively). Multivariate logistic regression analysis showed that the TG level was independently related to a 3-year eGFR decline ≥ 15% (P = .004; OR = 2.316). There was a significant linear relationship between the eGFR decline and TG level (P = .002). Patients with a TG concentration > 1.7 mmol/L had a more apparent decrease in the eGFR (P < .05). For elderly patients with T2DM and an eGFR < 90 mL/min/1.73m2, the TG level may be an important risk factor for deteriorating renal function that warrants actively intervention.
摘要：
2型糖尿病（T2DM）是肾功能受损患者的危险因素。T2DM诱导的糖尿病肾病（DKD）的发病通常是亚临床的，有可能导致终末期肾病.在本研究中，确定了老年T2DM患者DKD的影响因素。对2019年6月至2022年12月≥60岁T2DM患者进行回顾性队列研究。Cockcroft-Gault公式用于估算肾小球滤过率。收集估计肾小球滤过率(eGFR)<90mL/min/1.73m2患者的临床信息和生化指标。根据3年eGFR下降<15%和≥15%对患者进行分组。比较两组间差异,分析3年eGFR下降≥15%的影响因素。共纳入242名患者，包括3年eGFR下降<15％的组的154和3年eGFR下降≥15％的组的88。单因素logistic回归分析显示,吸烟,甘油三酯（TG）和高密度脂蛋白水平与3年eGFR下降≥15％有关（分别为P=.039，P<.001和P=.011）。多因素logistic回归分析显示,TG水平与3年eGFR下降≥15%存在独立相关(P=.004;OR=2.316)。eGFR下降与TG水平呈显著线性关系(P=0.002)。TG浓度>1.7mmol/L的患者eGFR下降更明显（P<0.05）。对于eGFR<90mL/min/1.73m2的老年T2DM患者，TG水平可能是肾功能恶化的重要危险因素，值得积极干预。
