Type II diabetes mellitus is a risk factor for heart failure in pre-dialysis patients.
Type II diabetes mellitus is a risk factor for heart failure in pre-dialysis patients.
复制标题
II型糖尿病是透析前患者心力衰竭的危险因素。
DOI：
10.1111/j.1744-9987.2012.01090.x
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Sasaki S.
中科院分区：
文献类型：
--
作者：
Kuwahara M;Ishigami J;Shikuma S;Akita W;Mori Y; Asai T;Tsukamoto y Adachi S;Noda Y;Rai T;Uchida S;Sasaki S.
慢性肾病（CKD）会增加患心力衰竭（HF）和缺血性心脏病（IHD）等心血管疾病的风险。 CKD 并发 HF 患者开始血液透析时的特征尚未评估。我们在这项研究中招募了 347 名患者，并比较了患有 (n= 105) 和不患有 (n= 242) 心力衰竭组之间的性别、年龄、体重指数、实验室数据、病因、并发症和超声心动图结果。 II型糖尿病肾病和估计肾小球滤过率（eGFR；mL/min/1.73 m2）是心力衰竭的独立因素（OR：3.004，95% CI：1.754至5.146和OR：1.215，95% CI：1.101至1.330，[per分别为 1 mL/min/1.73 m2 增加]）。较高的 GFR 似乎不是心力衰竭的危险因素，可能是因为心力衰竭组包括需要定期透析以预防致命性心力衰竭的患者，即使他们的肾功能并未极度恶化。两组之间的高血压、IHD 患病率以及体重指数、甘油三酯和低密度脂蛋白胆固醇值没有差异。超声心动图数据显示，左心室质量指数是心力衰竭的独立危险因素（OR：1.006，95% CI：1.001至1.012，每增加1 g/m2），超过一半的患者出现左心室舒张功能障碍。我们的研究结果表明，不仅 CKD，而且 II 型 DM 都是左心室功能障碍的潜在风险，导致透析前 CKD 患者发生心力衰竭和缺血性心脏病。
Chronic kidney disease (CKD) increases the risk of developing cardiovascular diseases such as heart failure (HF) and ischemic heart disease (IHD). The characteristics of patients with CKD complicated with HF at the time of starting hemodialysis have not yet been evaluated. We enrolled 347 patients in this study and compared gender, age, body mass index, laboratory data, causative disease, complications, and echocardiographic findings between groups with (n= 105) and without (n= 242) HF. Type II diabetic nephropathy and estimated glomerular filtration rate (eGFR; mL/min/1.73 m2) were the independent factors for HF (OR: 3.004, 95% CI: 1.754 to 5.146 and OR: 1.215, 95% CI: 1.101 to 1.330, [per 1 mL/min/1.73 m2increase], respectively). The higher GFR appeared to be not a risk factor for HF, probably because the HF group included patients who required periodic dialysis to prevent fatal HF, even if their renal function was not extremely deteriorated. The prevalence of hypertension, IHD and values of body mass index, triglycerides, and LDL‐cholesterol did not differ between these two groups. Echocardiographic data showed that left ventricular mass index was an independent risk factor for HF (OR: 1.006, 95% CI: 1.001 to 1.012, per 1 g/m2increase) and more than half of the patients appeared to have left ventricular diastolic dysfunction. Our findings suggest that not only CKD, but also type II DM, is a potent risk for left ventricular dysfunction, which causes HF and IHD in pre‐dialysis patients with CKD.