Association of Serum 25 (OH) Vitamin D With Chronic Kidney Disease Progression in Type 2 Diabetes.
Association of Serum 25 (OH) Vitamin D With Chronic Kidney Disease Progression in Type 2 Diabetes.
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血清 25 (OH) 维生素 D 与 2 型糖尿病慢性肾病进展的关系
DOI：
10.3389/fendo.2022.929598
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发表时间：
2022
影响因子：
5.2
通讯作者：
Yuan Y
中科院分区：
文献类型：
--
作者：
Duan S;Lu F;Wu B;Zhang C;Nie G;Sun L;Huang Z;Guo H;Zhang B;Xing C;Yuan Y
越来越多的证据表明，维生素D水平与2型糖尿病（T2 DM）和慢性肾脏疾病（CKD）有关，因为它具有各种额外的作用。因此，本研究旨在评估25-羟基维生素D [25（OH）D]水平与T2 DM临床病理特征和CKD进展的相关性。回顾性纳入了总计182例CKD 1 - 4期（G1-G4）T2 DM患者。通过Kaplan-Meier生存分析和考克斯比例风险模型确定与CKD进展相关的血清25（OH）D水平。我们进一步对75名参与者的血清25（OH）D水平进行了时间加权平均（TWA）敏感性分析，以加强研究结果。研究参与者的中位血清25（OH）D水平为26（IQR，14; 39）nmol/L。中位随访时间为42个月，在此期间，70例（38%）患者面临CKD进展。在Kaplan-Meier分析中，血清25（OH）D水平最低三分位数的累积肾脏结局显著较高（P < 0.001）。考克斯比例风险回归模型分析结果显示，血清25（OH）D水平最低三分位数患者的CKD进展风险显著高于血清25（OH）D水平最高三分位数患者（P = 0.03）。通过对血清25（OH）D水平TWA数据的进一步敏感性分析，这些关系仍然稳健，显示血清25（OH）D水平TWA较低与T2 DM伴CKD患者的不利肾脏结局之间存在独立相关性。我们的研究结果表明，25（OH）D水平降低的T2 DM患者肾功能恶化。血清25（OH）D的基线水平和TWA水平较低均与T2 DM患者CKD进展风险增加相关，这表明从生命早期长期维持最佳维生素D水平可能与T2 DM患者未来发生CKD的风险降低相关。
Growing evidence demonstrated that vitamin D levels had been linked to type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) in light of various extraskeletal effects. Therefore, the present study aimed to evaluate the association of 25-hydroxyvitamin D [25(OH)D] level with the clinicopathological features and CKD progression in T2DM. A total of 182 patients with T2DM with CKD stages 1 through 4 (G1–G4) were retrospectively included. Identification of the serum 25(OH)D level associated with CKD progression was executed by Kaplan–Meier survival analysis and Cox proportional hazards models. We further performed sensitivity analyses with a time-weighted average (TWA) of the serum 25(OH)D level in 75 participants to reinforce the findings. The median serum 25(OH)D level was 26 (IQR, 14; 39) nmol/L in the study participants. Median follow-up time was 42 months, during which 70 (38%) patients confronted CKD progression. Cumulative kidney outcomes were significantly higher in the lowest tertile of the serum 25(OH)D level in Kaplan–Meier analyses (P < 0.001). Consistently, the analyses of Cox proportional hazards regression models indicated a significantly greater risk for CKD progression in the lowest tertile of the serum 25(OH)D level compared with the highest tertile of the serum 25(OH)D level (P = 0.03). These relationships remained robust with further sensitivity analysis of data with TWA of the serum 25(OH)D level, showing an independent association between lower TWA of the serum 25(OH)D level and an unfavorable renal outcome in patients with T2DM with CKD. Our findings demonstrated that patients with T2DM with a decreased 25(OH)D level had deteriorated renal function. Both lower levels of baseline and TWA of serum 25(OH)D were associated with an increased risk of CKD progression in patients with T2DM, which suggested that the long-term maintenance of optimal vitamin D levels from early in life might be associated with reduced future risk of CKD development in T2DM.
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影响因子：
20.3
作者：
Bouillon R;Marcocci C;Carmeliet G;Bikle D;White JH;Dawson-Hughes B;Lips P;Munns CF;Lazaretti-Castro M;Giustina A;Bilezikian J
通讯作者：
Bilezikian J
影响因子：
13.2
作者：
de Boer, Ian H.;Ioannou, George N.;Weiss, Noel S.
通讯作者：
Weiss, Noel S.
影响因子：
2.8
作者：
Chokhandre MK;Mahmoud MI;Hakami T;Jafer M;Inamdar AS
通讯作者：
Inamdar AS
影响因子：
5.8
作者：
Chaudhuri, Ajay;Ghanim, Husam;Arora, Pradeep
通讯作者：
Arora, Pradeep
影响因子：
4.6
作者：
Cozzolino M;Bernard L;Csomor PA
通讯作者：
Csomor PA