Comparison of cystatin C- and creatinine-based estimated glomerular filtration rates for predicting all-cause mortality in Japanese patients with type 2 diabetes: the Fukuoka Diabetes Registry
Comparison of cystatin C- and creatinine-based estimated glomerular filtration rates for predicting all-cause mortality in Japanese patients with type 2 diabetes: the Fukuoka Diabetes Registry
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DOI：
10.1007/s10157-016-1296-2
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发表时间：
2017-06-01
影响因子：
2.3
通讯作者：
Kitazono, Takanari
中科院分区：
文献类型：
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作者：
Ide, Hitoshi;Iwase, Masanori;Kitazono, Takanari
关于基于胱抑素C的估计肾小球滤过率(EGFR(Cys))对亚洲人群全因死亡率的预测能力的信息很少。我们比较了EGFR(Cys)对日本2型糖尿病患者全因死亡率的判别能力和基于肌酐的估计肾小球滤过率(EGFR(Cr))。根据EGFR(Cys)和EGFR(Cys)将4869名参与者分为四类(EGFR ae29、30-59、60-89和ae90ml/min/1.73m(2))，并进行了中位数3.3年的随访。150人死亡。与EGFR(Cr)ae90ml/min/1.73m(2)[危险比(HR)2.4(95%可信区间(95%CI)1.2~5.0)]相比，EGFR(Cys)aE29ml/min/1.73m(2)组全因死亡的多变量调整风险显著增加，而EGFR(Cys)59ml/min/1.73m(2)或更低[30~59ml/min/1.73m(2)]显著增加。HR 1.9(95%CI 1.1~3.5)；AE29ml/min/1.73m(2)，HR 5.8(95%CI 2.8~12.0)]。比较EGFR(Cys)和EGFR(Cr)，重新分类为较低和较高EGFR阶段的参与者比例分别为6.3%和28.8%。多因素调整后的全因死亡率比分别为1.8(95%CI 1.1~2.9)和0.7(95%CI 0.4~1.1)。考虑EGFR(Cys)和其他危险因素的模型的C统计量较包括EGFR(Cr)的模型显著增加。我们的研究结果表明，EGFR(Cys)与全因死亡率有更强的相关性，在预测日本2型糖尿病患者全因死亡率方面优于EGFR(Cr)。
There is little information about the predictive ability of cystatin C-based estimated glomerular filtration rates (eGFR(Cys)) for all-cause mortality in Asian populations. We compared the discriminatory ability of eGFR(Cys) for all-cause mortality with that of creatinine-based estimated glomerular filtration rates (eGFR(Cr)) in Japanese patients with type 2 diabetes.A total of 4869 participants were classified into four categories (eGFR ae29, 30-59, 60-89, and ae90 ml/min/1.73 m(2)) by eGFR(Cr) and eGFR(Cys), and followed up for a median of 3.3 years.150 deaths were identified. The multivariable-adjusted risk of all-cause mortality was significantly increased in eGFR(Cr) ae29 ml/min/1.73 m(2) compared with eGFR(Cr) ae90 ml/min/1.73 m(2) [hazard ratio (HR) 2.4 (95 % confidence interval (95 % CI) 1.2-5.0)], whereas it was significantly increased in eGFR(Cys) 59 ml/min/1.73 m(2) or lower [30-59 ml/min/1.73 m(2), HR 1.9 (95 % CI 1.1-3.5); ae29 ml/min/1.73 m(2), HR 5.8 (95 % CI 2.8-12.0)]. Comparing eGFR(Cys) with eGFR(Cr), the proportions of participants reclassified to lower and higher eGFR stages were 6.3 and 28.8 %, respectively. The multivariable-adjusted HRs for all-cause mortality were 1.8 (95 % CI 1.1-2.9) and 0.7 (95 % CI 0.4-1.1), respectively. The C statistic of the model including eGFR(Cys) and other risk factors was significantly increased compared with the model including eGFR(Cr). The net reclassification improvement and the integrated discrimination improvement were significantly positive.Our findings suggest that eGFR(Cys) has a stronger association with all-cause mortality and is superior to eGFR(Cr) for predicting all-cause mortality in Japanese patients with type 2 diabetes.