Silent cerebral infarction is associated with the development and progression of nephropathy in patients with type 2 diabetes
Silent cerebral infarction is associated with the development and progression of nephropathy in patients with type 2 diabetes
复制标题
无症状性脑梗死与2型糖尿病患者肾病的发生、进展相关
作者：
R. Bouchi;T. Babazono;Naoshi Yoshida;Izumi Nyumura;Kiwako Toya;Toshihide Hayashi;K. Hanai;N. Tanaka;A. Ishii;Y. Iwamoto
慢性肾脏病（CKD）是糖尿病患者心血管疾病的重要危险因素。 CKD的肾脏表现（白蛋白尿和肾小球滤过率降低）与无症状脑梗死（SCI）之间的关系引起关注；然而，大多数研究探讨了 CKD 成分对 SCI 患病率的影响。我们试图评估 SCI 与 2 型糖尿病患者肾病发生和进展之间的关系。我们研究了 366 名白蛋白尿正常（尿白蛋白与肌酐比值 [ACR] <30mg g–1，N=246）或微量白蛋白尿（ACR=30–299mg g–1，N=120）的 2 型糖尿病患者。 SCI 通过头颅 MRI 定义。主要终点是从正常尿蛋白尿进展为微量白蛋白尿或从尿白蛋白尿进展为大量白蛋白尿。主要终点的累积发生率使用 Kaplan-Meier 方法进行估计。使用 Cox 比例风险模型分析计算达到终点的风险估计。在中位随访 3.9 年期间，23 名正常白蛋白尿患者和 24 名微量白蛋白尿患者达到主要终点。 SCI患者（N=171）达到终点的发生率高于非SCI患者（N=195，对数秩检验P=0.020），多变量Cox回归模型的风险比为2.02（95%置信区间=1.09-3.72，P=0.025）。尽管糖尿病患者 SCI 和蛋白尿的常见发病机制尚不清楚，但 SCI 可能是 2 型糖尿病患者肾病进展的预测因子。
Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease in patients with diabetes. The relationship between renal manifestations of CKD (albuminuria and decreased glomerular filtration rate) and silent cerebral infarction (SCI) has attracted attention; however, most studies examined the effects of components of CKD on prevalence of SCI. We sought to assess the relationship between SCI and the development and progression of nephropathy in type 2 diabetic patients. We studied 366 type 2 diabetic patients with normoalbuminuria (urinary albumin-to-creatinine ratio [ACR] <30 mg g–1, N=246) or microalbuminuria (ACR=30–299 mg g–1, N=120). SCI was defined by cranial MRI. The primary end point was progression from normo- to microalbuminuria or from micro- to macroalbuminuria. The cumulative incidence of the primary end point was estimated using the Kaplan–Meier method. Risk estimates for reaching the end point were calculated using Cox proportional hazard model analyses. During a median follow-up period of 3.9 years, 23 normoalbuminuric and 24 microalbuminuric patients reached the primary end point. Patients with SCI (N=171) had a greater incidence of reaching the end point than those without SCI (N=195, P=0.020 by the log-rank test), with a hazard ratio of 2.02 (95% confidence interval=1.09–3.72, P=0.025) in the multivariate Cox regression model. Although the common pathogenesis of SCI and albuminuria in diabetic patients is still unclear, SCI may be a predictor of progression of nephropathy in type 2 diabetic patients.
影响因子：
7.7
作者：
Caramori, ML;Fioretto, P;Mauer, M
通讯作者：
Mauer, M