Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes.
Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes.
复制标题
2型糖尿病患者肾功能下降的性别差异。
DOI：
10.1155/2016/4626382
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发表时间：
2016
影响因子：
4.3
通讯作者：
Nakagawa K
中科院分区：
文献类型：
--
作者：
Kajiwara A;Kita A;Saruwatari J;Miyazaki H;Kawata Y;Morita K;Oniki K;Yoshida A;Jinnouchi H;Nakagawa K
目标。本研究旨在探讨2型糖尿病（T2 DM）患者肾功能下降的性别差异，重点关注早期肾功能损害危险因素的差异。方法.进行了一项基于临床的回顾性纵向研究（随访持续时间：8.1 ± 1.4年），以评估344例（247例男性和97例女性）日本T2 DM患者的年度估计肾小球滤过率（eGFR）变化的性别差异。对年度eGFR下降的风险因素的性别差异进行线性回归分析。结果女性eGFR的平均年变化为-3.5 ± 2.7%/年，男性为-2.0 ± 2.2%/年（P < 0.001）。基线视网膜病变和蛋白尿与eGFR下降幅度较大显著相关，与性别无关，而HbA 1c和LDL胆固醇水平仅与女性eGFR下降显著相关。在性别和HbA 1c、LDL-胆固醇、视网膜病变或蛋白尿水平之间观察到了对年度eGFR下降的交互作用。结论.对代谢控制不良的易感性增加似乎导致T2 DM女性肾功能不全风险升高。我们的研究强调了积极的治疗干预对改善早期代谢状况的重要性，特别是在女性中。
Aims. We aimed to investigate the sex differences in the renal function decline among patients with type 2 diabetic mellitus (T2DM), focusing on the differences in the risk factors at early stage of renal dysfunction. Methods. A clinic-based retrospective longitudinal study (follow-up duration: 8.1 ± 1.4 years) was conducted to assess the sex differences in the annual estimated glomerular filtration rate (eGFR) change in 344 (247 male and 97 female) Japanese T2DM patients. The sex differences in the risk factors of annual eGFR decline were subjected to linear regression analyses. Results. The mean annual eGFR change was −3.5 ± 2.7%/year in females and −2.0 ± 2.2%/year in males (P < 0.001). Baseline retinopathy and proteinuria were significantly associated with a larger eGFR decline, irrespective of sex, while HbA1c and LDL-cholesterol levels were significantly associated with an eGFR decline in females only. Interactive effects were observed between sex and the HbA1c, LDL-cholesterol, retinopathy, or proteinuria levels on the annual eGFR decline. Conclusions. The increased susceptibility to poor metabolic control seemed to contribute to a higher risk of renal dysfunction in females with T2DM. Our study highlights the importance of aggressive therapeutic intervention to improve metabolic profiles at early stage, especially in females.