Changes in proteinuria and the risk of myocardial infarction in people with diabetes or pre-diabetes: a prospective cohort study.
Changes in proteinuria and the risk of myocardial infarction in people with diabetes or pre-diabetes: a prospective cohort study.
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糖尿病或糖尿病前期患者蛋白尿的变化和心肌梗死的风险：一项前瞻性队列研究
DOI：
10.1186/s12933-017-0586-7
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发表时间：
2017-08-15
影响因子：
9.3
通讯作者：
Guo X
中科院分区：
文献类型：
--
作者：
Wang A;Sun Y;Liu X;Su Z;Li J;Luo Y;Chen S;Wang J;Li X;Zhao Z;Zhu H;Wu S;Guo X
背景糖尿病或糖尿病前期患者的蛋白尿变化与心肌梗死 (MI) 之间的关系仍不清楚。我们的目的是评估两年内蛋白尿变化对糖尿病或糖尿病前期患者心肌梗死发病率的预测价值和独立作用。方法根据开滦前瞻性队列研究的基线和2年试纸筛查结果，将参与者分为四类：无蛋白尿、缓解性蛋白尿、偶发性蛋白尿和持续性蛋白尿。建立了四个多变量 Cox 比例风险模型来调整不同混杂协变量的影响。结果在这项研究的 17,625 名参与者中，在中位随访 6.69 年期间，总共发生了 238 起心肌梗死事件。调整人口统计学因素和实验室指标后，持续性蛋白尿与心肌梗死发生率之间的关联得以维持（风险比 [HR] 2.50，95% 置信区间 [CI] 1.48–4.22）。据观察，从 2006 年到 2008 年，蛋白尿的每一次减少都会导致 MI 发病率下降 21%（HR 0.79，95% CI 0.68-0.90）。蛋白尿变化与糖尿病之间的相互作用已被证实，但对 MI 没有影响 (P= 0.3371)。 结论 持续性蛋白尿是糖尿病前期和糖尿病人群 MI 发生的独立危险因素。这些发现可能有助于临床医生解释门诊患者蛋白尿的变化，并为糖尿病前期或糖尿病患者提供可能的预防方法。
BackgroundThe relationship between changes in proteinuria and myocardial infarction (MI) remains unclear in people with diabetes or pre-diabetes. We aimed to evaluate the predictive value and independent role of changes in proteinuria over a 2-year period in the incidence of MI in people with diabetes or pre-diabetes.MethodsBased on the baseline and 2-year dipstick screening results from the Kailuan prospective cohort study, participants were divided into four categories: no proteinuria, remittent proteinuria, incident proteinuria, and persistent proteinuria. Four multivariable Cox proportional hazard models were built to adjust for the effects of different confounding covariates.ResultsAmong the 17,625 participants in this study, there were a total of 238 incidents of MI during a median follow-up of 6.69 years. After adjusting for demography factors and laboratory indices, the association between persistent proteinuria and MI incidence was maintained (hazard ratio [HR] 2.50, 95% confidence interval [CI] 1.48–4.22). Every decrease of proteinuria from 2006 to 2008 was observed to be responsible for a 21% decline of MI incidence (HR 0.79, 95% CI 0.68–0.90). The interaction between changes in proteinuria and diabetes was confirmed with no effect on MI (P= 0.3371).ConclusionsPersistent proteinuria is an independent risk factor for MI incidence in the pre-diabetic and diabetic population. These findings may help clinicians to interpret proteinuria changes in the outpatient setting and provide possible preventive approaches for people with pre-diabetes or diabetes.
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影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
身体成分对冠心病患者肾功能的影响及其预后意义：一项回顾性队列研究
影响因子：
9.3
作者：
Peng Y;Wang H;Chen F;Huang FY;Xia TL;Liao YB;Chai H;Wang PJ;Zuo ZL;Liu W;Zhang C;Li YJ;Gui YY;Chen M;Huang DJ
通讯作者：
Huang DJ
影响因子：
9.3
作者：
Bouchi R;Ohara N;Asakawa M;Nakano Y;Takeuchi T;Murakami M;Sasahara Y;Numasawa M;Minami I;Izumiyama H;Hashimoto K;Yoshimoto T;Ogawa Y
通讯作者：
Ogawa Y
影响因子：
3.7
作者：
Konno S;Munakata M
通讯作者：
Munakata M
影响因子：
3
作者：
Afghahi, Hanri;Miftaraj, Mervete;Svensson, Maria K.
通讯作者：
Svensson, Maria K.