B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study
B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study
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DOI：
10.1507/endocrj.ej17-0256
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Miyake, Yoshihiro
中科院分区：
文献类型：
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作者：
Furukawa, Shinya;Sakai, Takenori;Miyake, Yoshihiro
在2型糖尿病患者中，B型利钠肽(BNP)与肾功能之间的关联仍存在争议。因此，我们在日本2型糖尿病患者中调查了这一问题。这项研究包括687名日本2型糖尿病患者。根据分布情况，按四分位点划分BNP水平。我们使用了四种关于肾功能的结果：1)慢性肾脏疾病(CKD)：估计的肾小球滤过率(EGFR)和lt；60ml/min/1.72m(2)，2)晚期CKD：EGFR和lt；30ml/min/1.72m(2)，3)微量白蛋白尿：尿白蛋白肌酐比率(UACR)和Gt；=30 mg/g肌酐，以及4)大量白蛋白尿：UACR>；=300 mg/g肌酐。CKD、进展期CKD、微量白蛋白尿和大量白蛋白尿的患病率分别为27.4%、2.5%、31.4%和9.3%。最高BNP水平与微量白蛋白尿和大量白蛋白尿独立正相关(校正OR值分别为2.61[95%CI：1.53~4.49]和3.45[95%CI：1.46~8.72])。高BNP与进展期CKD或CKD无关。在脑钠素水平与晚期慢性肾脏病、微量白蛋白尿和大量白蛋白尿之间有统计学意义的正暴露-反应关系(趋势p分别为0.047、0.001和0.003)。在日本2型糖尿病患者中，BNP水平可能独立地与晚期CKD、微量白蛋白尿和大量白蛋白尿呈正相关，而与CKD无关。
Among patients with type 2 diabetes mellitus, the association between B-type natriuretic peptide (BNP) and renal function remains controversial. We therefore investigated this issue among Japanese patients with type 2 diabetes mellitus. This study included 687 Japanese patients with type 2 diabetes mellitus. BNP levels were divided at quartile points on the basis of the distribution. We used four outcomes regarding the renal function: 1) chronic kidney disease (CKD): estimated glomerular filtration rate (eGFR) < 60mL/min/1.72m(2), 2) advanced CKD: eGFR < 30mL/min/1.72m(2), 3) microalbuminuria: urinary albumin creatinine ratio (UACR) >= 30 mg/g creatinine, and 4) macroalbuminuria: UACR >= 300 mg/g creatinine. The prevalence values of CKD, advanced CKD, microalbuminuria, and macroalbuminuria were 27.4, 2.5%, 31.4%, and 9.3%, respectively. Highest BNP (>= 39.2 ng/mL) was independently positively associated with microalbuminuria and macroalbuminuria (adjusted ORs, 2.61 [95% CI: 1.53-4.49] and 3.45 [95% CI: 1.46-8.72], respectively). High BNP was not associated with advanced CKD or CKD. There was a statistically significant positive exposure-response relationships between the BNP level and advanced CKD, microalbuminuria, and macroalbuminuria (p for trend = 0.047, 0.001, and 0.003, respectively). BNP level may be independently positively associated with advanced CKD, microalbuminuria, and macroalbuminuria but not CKD in Japanese patients with type 2 diabetes mellitus.