Impact of kidney function and urinary protein excretion on intima-media thickness in Japanese patients with type 2 diabetes
Impact of kidney function and urinary protein excretion on intima-media thickness in Japanese patients with type 2 diabetes
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DOI：
10.1007/s10157-015-1088-0
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发表时间：
2015-10-01
影响因子：
2.3
通讯作者：
Wada, Takashi
中科院分区：
文献类型：
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作者：
Nakade, Yusuke;Toyama, Tadashi;Wada, Takashi
颈动脉回声指数[内膜中层厚度（IMT）]是心血管疾病的常用替代指标;然而，慢性肾脏疾病（CKD）对IMT变化的影响尚不清楚。我们通过纵向分析，在有和没有2型糖尿病的受试者中检查CKD和IMT之间的关系。根据颈动脉超声指标测定IMT。以IMT为因变量，动脉粥样硬化相关因素为自变量，采用多元线性回归分析IMT与动脉粥样硬化危险因素的关系（年龄、性别、收缩压、总胆固醇、体重指数、估计肾小球滤过率（eGFR）、尿酸、吸烟指数、抗高血压药物数量、他汀类药物使用、尿蛋白水平、既往心血管事件、糖化血红蛋白、和糖尿病病程）作为自变量。研究人群由70.3%的男性受试者组成。糖尿病患者占总人口的64.4%。平均随访时间为2.2 +/- A 1.5年。在所有受试者中，IMT的改变往往与收缩压（+10 mmHg）（β =-0.0084，p = 0.09）和eGFR（+10 mL/min/1.73 m（2））（β =-0.0049，p = 0.06）相关。在无糖尿病的受试者中，IMT的改变与eGFR（+10 mL/min/1.73 m（2））相关（β =-0.0104，p = 0.03），并倾向于与收缩压（+10 mmHg）相关（β = 0.0094，p = 0.06）。在糖尿病患者中没有发现显著的相关性。低eGFR与颈动脉厚度的进展相关，而与非糖尿病患者中常见的心血管危险因素无关。
Carotid echo indexes [intima-media thickness (IMT)] are commonly used surrogate markers for cardiovascular disease; however, the impacts of chronic kidney disease (CKD) on changes in IMT are unclear. We examined associations between CKD and IMT in participants with and without type 2 diabetes through longitudinal analysis.In total, 424 subjects were enrolled in this study. IMT was measured as per carotid echo indexes. Relationships between IMT and risk factors were analyzed using multiple linear regression analysis, in which we defined IMT as the dependent variable and atherosclerosis-related factors (age, sex, systolic pressure, total cholesterol, body mass index, estimated glomerular filtration rate (eGFR), uric acid, smoking index, number of antihypertensive drugs, statin use, urinary protein levels, past cardiovascular event, glycated hemoglobin, and diabetes duration) as independent variables.The study population was composed of 70.3 % male subjects. Participants with diabetes accounted for 64.4 % of the total population. The mean follow-up duration was 2.2 +/- A 1.5 years. Alterations in IMT tended to be associated with systolic blood pressure (+10 mmHg) (beta = -0.0084, p = 0.09) and eGFR (+10 mL/min/1.73 m(2)) (beta = -0.0049, p = 0.06) in all participants. In participants without diabetes, alterations in IMT were associated with eGFR (+10 mL/min/1.73 m(2)) (beta = -0.0104, p = 0.03) and tended to be associated with systolic blood pressure (+10 mmHg) (beta = 0.0094, p = 0.06). No significant relationships were found in participants with diabetes.Low eGFR was associated with progression of carotid thickness independent of common cardiovascular risk factors in non-diabetic participants.