Association of race/ethnicity, inflammation, and albuminuria in patients with diabetes and early chronic kidney disease.
Association of race/ethnicity, inflammation, and albuminuria in patients with diabetes and early chronic kidney disease.
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DOI：
10.2337/dc13-0013
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发表时间：
2014-04
期刊：
影响因子：
16.2
通讯作者：
Nicholas SB
中科院分区：
文献类型：
--
作者：
Sinha SK;Shaheen M;Rajavashisth TB;Pan D;Norris KC;Nicholas SB
与白人相比，非裔美国人（AAs）和西班牙裔美国人有更高的糖尿病和终末期肾脏疾病，但早期慢性肾脏疾病（CKD）相似或更低。炎症在糖尿病相关CKD的发病机制中起关键作用。我们假设，与普通人群相比，美国裔和西班牙裔美国人与白人相比，早期糖尿病CKD和全身性炎症标志物的患病率更高。我们分析了1999-2008年全国健康与营养调查中2310例年龄≥20岁且空腹血糖(FPG)≥126 mg/dL的糖尿病患者。我们对早期CKD患者（尿白蛋白排泄量[UAE]≥30 μg/mL，肾小球滤过率≥60 mL/min/1.73 m2）进行多元线性回归，通过调整人口统计学、糖尿病病程、FPG、血红蛋白A1c、尿酸、白细胞计数、药物使用、心血管疾病和相关参数，检验UAE与c反应蛋白（CRP）之间的关系。在糖尿病患者中，西班牙裔和美国裔的早期CKD患病率高于白人（P < 0.0001）。美国人在CRP≥0.2 mg/dL时有较高的调整优势比（AOR 1.81 [95% CI 1.19-2.78]），西班牙裔人在UAE≥30 μg/mL时有较高的调整优势比（AOR 1.65[1.07-2.54]）。在校正混杂变量的回归模型中，与白人相比，在西班牙裔中，UAE与CRP中位数（CRP 0.20-0.56 mg/dL, P = 0.001）和最高CRP分位数（CRP≥0.57 mg/dL, P = 0.01）之间存在显著关联，但在aa中仅与CRP中位数（P = 0.04）相关。与白人相比，AAs和西班牙裔糖尿病患者的早期CKD患病率更高，这与UAE和/或CRP显著相关。
African Americans (AAs) and Hispanics have higher diabetes and end-stage renal disease but similar or lower early chronic kidney disease (CKD) compared with whites. Inflammation plays a critical role in the pathogenesis of diabetes-related CKD. We postulated that in contrast to the general population, AAs and Hispanics have a higher prevalence of early diabetic CKD and systemic inflammatory markers compared with whites. We analyzed the National Health and Nutrition Examination Survey 1999–2008 of 2,310 diabetic patients aged ≥20 years with fasting plasma glucose (FPG) ≥126 mg/dL. We performed multiple linear regression among patients with early CKD (urinary albumin excretion [UAE] ≥30 μg/mL and estimated glomerular filtration rate ≥60 mL/min/1.73 m2) to test the relationship between UAE and C-reactive protein (CRP) by race/ethnicity, adjusting for demographics, diabetes duration, FPG, hemoglobin A1c, uric acid, white blood cell count, medication use, cardiovascular disease, and related parameters. In patients with diabetes, the prevalence of early CKD was greater among Hispanics and AAs than whites (P < 0.0001). AAs had higher adjusted odds ratio (AOR) for CRP ≥0.2 mg/dL (AOR 1.81 [95% CI 1.19–2.78]), and Hispanics had higher AOR for UAE ≥30 μg/mL (AOR 1.65 [1.07–2.54]). In a regression model adjusted for confounding variables, there was a significant association between UAE and CRP in the mid-CRP tertile (CRP 0.20–0.56 mg/dL, P = 0.001) and highest CRP tertile (CRP ≥0.57 mg/dL, P = 0.01) for Hispanics, but only in the mid-CRP tertile (P = 0.04) for AAs, compared with whites. AAs and Hispanics with diabetes have a higher prevalence of early CKD compared with whites, which is significantly associated with UAE and/or CRP.
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影响因子：
8.2
作者：
Liu, F.;Chen, H. Y.;Lan, H. Y.
通讯作者：
Lan, H. Y.
影响因子：
13.2
作者：
Erlinger, TP;Tarver-Carr, ME;Brancati, FL
通讯作者：
Brancati, FL
影响因子：
19.6
作者：
Festa, A;D'Agostino, R;Haffner, SM
通讯作者：
Haffner, SM
影响因子：
2.5
作者：
Nguyen, Duy;Ping, Fu;Chadban, Steven J.
通讯作者：
Chadban, Steven J.
DOI：
10.2215/cjn.03010608
发表时间：
2009-01-01
影响因子：
9.8
作者：
Niewczas, Monika A.;Ficociello, Linda H.;Krolewski, Andrzej S.
通讯作者：
Krolewski, Andrzej S.