Identifying parameters to distinguish non-diabetic renal diseases from diabetic nephropathy in patients with type 2 diabetes mellitus: a meta-analysis.
Identifying parameters to distinguish non-diabetic renal diseases from diabetic nephropathy in patients with type 2 diabetes mellitus: a meta-analysis.
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DOI：
10.1371/journal.pone.0064184
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Chen XM
中科院分区：
文献类型：
--
作者：
Liang S;Zhang XG;Cai GY;Zhu HY;Zhou JH;Wu J;Chen P;Lin SP;Qiu Q;Chen XM
糖尿病患者的肾损害包括糖尿病肾病（DN）和非糖尿病肾病（NDRD）。DN和NDRD的临床诊断价值仍无定论。我们对文献进行了荟萃分析，以确定NDRD的预测因素，并比较DN和NDRD的临床特征以进行鉴别诊断。我们检索了PubMed（1990年至2012年1月）、Embase（1990年至2009年2月）和CNKI（1990年至2012年1月），以确定入组DN和NDRD患者的研究。然后，对研究的质量进行评估，并提取数据。结果总结为二分结局的比值比（OR）和连续结局的加权平均差（WMD）。纳入了26项相关研究（2，322例患者）。荟萃分析显示，无糖尿病视网膜病变（DR）可预测NDRD（OR，0.15; 95%置信区间[CI]，0.09-0.26，p<0.00001）。糖尿病（DM）病程较短也可预测NDRD（加权平均差异，−34.67; 95%CI，−45.23-−24.11，p<0.00001）。NDRD患者的糖化血红蛋白（HbA 1C %）、血压（BP）和总胆固醇水平较低，而甘油三酯和体重指数较高。其他临床参数，包括年龄，24小时尿蛋白排泄量，血清肌酐，肌酐清除率，血尿素氮，肾小球滤过率在NDRD和DN患者之间没有差异。我们发现，无DR、DM病程短、HbA 1C低、血压低可能有助于区分糖尿病患者的NDRD和DN。这可以帮助临床医生做出安全可靠的诊断，并导致更有效的治疗。
Renal injuries in patients with diabetes include diabetic nephropathy (DN) and non-diabetic renal diseases (NDRD). The value of a clinical diagnosis of DN and NDRD remains inconclusive. We conducted a meta-analysis of the literature to identify predictive factors of NDRD and to compare the clinical characteristics of DN and NDRD for differential diagnosis. We searched PubMed (1990 to January 2012), Embase (1990 to February 2009), and CNKI (1990 to January 2012) to identify studies that enrolled patients with DN and NDRD. Then, the quality of the studies was assessed, and data were extracted. The results were summarized as odds ratios (ORs) for dichotomous outcomes and weighted mean differences (WMDs) for continuous outcomes. Twenty-six relevant studies with 2,322 patients were included. The meta-analysis showed that the absence of diabetic retinopathy (DR) predicts NDRD (OR, 0.15; 95% confidence interval [CI], 0.09–0.26, p<0.00001). A shorter duration of diabetes mellitus (DM) also predicted NDRD (weighted mean difference, −34.67; 95% CI, −45.23–−24.11, p<0.00001). The levels of glycosylated hemoglobin (HbA1C%), blood pressure (BP), and total cholesterol were lower in patients with NDRD, whereas triglycerides and body mass index were higher. Other clinical parameters, including age, 24-h urinary protein excretion, serum creatinine, creatinine clearance, blood urea nitrogen, and glomerular filtration rate were not different between patients with NDRD and DN. We identified that the absence of DR, shorter duration of DM, lower HbA1C, and lower BP may help to distinguish NDRD from DN in patients with diabetes. This could assist clinicians in making a safe and sound diagnosis and lead to more effective treatments.
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影响因子：
19.6
作者：
Christensen, PK;Larsen, S;Parving, HH
通讯作者：
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DOI：
10.1111/j.1742-1241.2008.01753.x
发表时间：
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影响因子：
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