Sudomotor dysfunction independently predicts incident cardiovascular-renal events and all-cause death in type 2 diabetes: the Joint Asia Diabetes Evaluation register.
Sudomotor dysfunction independently predicts incident cardiovascular-renal events and all-cause death in type 2 diabetes: the Joint Asia Diabetes Evaluation register.
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DOI：
10.1093/ndt/gfy154
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发表时间：
2019-08-01
期刊：
影响因子：
--
通讯作者：
Kong APS
中科院分区：
文献类型：
--
作者：
Lim LL;Fu AWC;Lau ESH;Ozaki R;Cheung KKT;Ma RCW;Luk AOY;Chan JCN;Kong APS
早期发现和危险因素控制可以预防慢性肾脏疾病（CKD）的进展。评估外周自主神经功能障碍可以检测2型糖尿病（T2D）心血管-肾脏事件的发生。SUDOSCAN是一种非侵入性工具，可提供年龄调整的电化学皮肤电导（ESC）复合评分，包括手/脚ESC测量值，得分≤53表示sudommotor功能障碍。2012 - 2013年，2833名中国成年人连续接受了结构化糖尿病评估；到2015年，2028名没有既往存在心血管疾病（CVD）和CKD的参与者被监测心血管肾脏事件的发生率。在这个前瞻性队列中{平均年龄57.0[标准差10.0]岁；中位T2D持续时间为7.0年[四分位数间距（IQR） 3.0-13.0]年；男性56.1%;72.5%不吸烟者;基线ESC综合评分60.7 (SD 14.5)}, 163（8.0%）和25（1.2%）参与者分别在2.3年随访后发生CKD和CVD事件。CKD、CVD和全因死亡的ESC综合评分每降低1个单位的校正风险比（aHRs）分别为1.02[95%可信区间（CI） 1.01-1.04]、1.04（1.00-1.07）和1.04（1.00-1.08）。与ESC综合评分bbbb53的参与者相比，评分≤53的参与者CKD的aHR为1.56 (95% CI 1.09-2.23)， CVD的aHR为3.11 (95% CI 1.27-7.62)，独立于常见风险标志物。当加入临床变量（性别和糖尿病病程）时，ESC综合评分改善了对CKD风险适当重新分类的所有结果的区分。较低的ESC综合评分可以独立预测心血管-肾脏事件的发生和T2D的死亡，这可能会改善早期干预的筛查策略。
Early detection and risk factor control prevent chronic kidney disease (CKD) progression. Evaluation of peripheral autonomic dysfunction may detect incident cardiovascular–renal events in type 2 diabetes (T2D). SUDOSCAN, a non-invasive tool, provides an age-adjusted electrochemical skin conductance (ESC) composite score incorporating hands/feet ESC measurements, with a score ≤53 indicating sudomotor dysfunction. A consecutive cohort of 2833 Chinese adults underwent structured diabetes assessment in 2012–13; 2028 participants without preexisting cardiovascular disease (CVD) and CKD were monitored for incident cardiovascular–renal events until 2015. In this prospective cohort {mean age 57.0 [standard deviation (SD) 10.0] years; median T2D duration 7.0 [interquartile range (IQR) 3.0–13.0] years; 56.1% men; 72.5% never-smokers; baseline ESC composite score 60.7 (SD 14.5)}, 163 (8.0%) and 25 (1.2%) participants developed incident CKD and CVD, respectively, after 2.3 years of follow-up. The adjusted hazard ratios (aHRs) per 1-unit decrease in the ESC composite score for incident CKD, CVD and all-cause death were 1.02 [95% confidence interval (CI) 1.01–1.04], 1.04 (1.00–1.07) and 1.04 (1.00–1.08), respectively. Compared with participants with an ESC composite score >53, those with a score ≤53 had an aHR of 1.56 (95% CI 1.09–2.23) for CKD and 3.11 (95% CI 1.27–7.62) for CVD, independent of common risk markers. When added to clinical variables (sex and duration of diabetes), the ESC composite score improved discrimination of all outcomes with appropriate reclassification of CKD risk. A low ESC composite score independently predicts incident cardiovascular–renal events and death in T2D, which may improve the screening strategy for early intervention.
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影响因子：
3.7
作者：
Luk AO;Fu WC;Li X;Ozaki R;Chung HH;Wong RY;So WY;Chow FC;Chan JC
通讯作者：
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影响因子：
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168.9
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作者：
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