Risk of End-Stage Renal Disease in Patients With Systemic Lupus Erythematosus and Diabetes Mellitus: A Danish Nationwide Cohort Study.
Risk of End-Stage Renal Disease in Patients With Systemic Lupus Erythematosus and Diabetes Mellitus: A Danish Nationwide Cohort Study.
复制标题
DOI：
10.1002/acr.25091
复制
发表时间：
2023-09
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
--
作者：
系统性红斑狼疮（SLE）患者发生终末期肾病（ESRD）的风险增加。本研究旨在确定糖尿病（DM）是否会增加SLE患者的ESRD风险。通过丹麦国家患者登记处，我们确定了1996年1月1日至2018年7月31日期间诊断为SLE的3，178例成人患者。DM定义为首次因DM联系医院的日期或首次开抗糖尿病药物处方的日期。ESRD定义为丹麦国家患者登记处首次登记的透析、肾移植或终末期肾功能不全。比较SLE合并糖尿病（SLE-DM）和非糖尿病（SLE-non-DM）患者终末期肾病（ESRD）的发生率。根据性别、年龄、教育水平和高血压（基线或随访期间）分层，计算校正基线时性别、年龄、教育水平和职业状况的风险比（HR）。还针对高血压调整了总体风险比（HR）。SLE-DM组包括290名患者，其中77%为女性，而SLE-non-DM组2，859名患者中有85%为女性。与SLE非DM患者相比，SLE-DM患者的ESRD风险高3倍（多变量校正HR 3.3 [95%置信区间1.8-6.1]）。在分层多变量校正分析中，DM增加了女性和男性、基线时年龄≥50岁的患者、基线时教育水平低的患者以及伴随高血压的患者的ESRD发生率。我们的研究结果表明，SLE合并糖尿病患者有一个显着更高的风险发展为终末期肾病相比，SLE患者没有糖尿病。
The risk of end-stage renal disease (ESRD) is increased in patients with systemic lupus erythematosus (SLE). This study was undertaken to determine whether diabetes mellitus (DM) increases ESRD risk in a large inception cohort of SLE patients. By means of the Danish National Patient Registry, we identified 3,178 adult patients diagnosed as having SLE between January 1, 1996, and July 31, 2018. DM was defined as the date of first hospital contact for DM or date of a first prescription of an antidiabetic drug. ESRD was defined as first registration of dialysis, renal transplant, or terminal renal insufficiency in the Danish National Patient Registry. ESRD incidence was compared between SLE patients with DM (SLE–DM) and those without DM (SLE–non-DM). Hazard ratios (HRs), adjusted for sex, age, educational level, and occupational status at baseline were calculated for sex, age, educational level, and hypertension (at baseline or during follow-up) strata. The overall hazard ratio (HR) was also adjusted for hypertension. The SLE–DM group included 290 patients, of whom 77% were female, compared with 85% of the 2,859 patients in the SLE–non-DM group. SLE–DM patients had a 3 times higher risk of ESRD compared with SLE–non-DM patients (multivariable-adjusted HR 3.3 [95% confidence interval 1.8–6.1]). In stratified multivariable-adjusted analyses, DM increased the rate of ESRD in women and men, patients ≥50 years old at baseline, those with low educational level at baseline, and those with concomitant hypertension. Our findings indicate that SLE patients with DM have a markedly higher risk of developing ESRD compared with SLE patients without DM.
影响因子：
5.2
作者：
Wang Y;Zhang J;Zhang J;Wu Y;Zhang R;Ren H;Cooper ME;Liu F
通讯作者：
Liu F