Constipation and diabetic kidney disease: The Fukuoka Diabetes Registry
Constipation and diabetic kidney disease: The Fukuoka Diabetes Registry
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DOI：
10.1007/s10157-021-02105-9
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发表时间：
2021-06-26
影响因子：
2.3
通讯作者：
Kitazono, Takanari
中科院分区：
文献类型：
--
作者：
Ohkuma, Toshiaki;Iwase, Masanori;Kitazono, Takanari
背景 尽管缺乏糖尿病患者的证据，但便秘已被证明与终末期肾病或慢性肾病的较高风险相关。本研究的目的是检查便秘与糖尿病肾病（DKD）之间的关联。方法 根据是否存在便秘（排便频率< 3 次/周和/或服用泻药）对 4826 名日本 2 型糖尿病门诊患者进行分类。 DKD 定义为存在估计肾小球滤过率降低（eGFR < 60 ml/min/1.73 m(2)）和/或白蛋白尿（尿白蛋白与肌酐比率 >= 30 mg/g）。通过逻辑回归模型计算 DKD 存在的优势比。结果 与没有便秘的参与者相比，便秘患者发生 DKD 的年龄和性别调整优势比为 1.58（95% 置信区间 1.38-1.82）。在对潜在的混杂因素进行调整后，这种关联仍然存在。排便频率减少和泻药使用也与 DKD 患病率升高显着相关。总体而言，即使单独分析 eGFR 下降和蛋白尿，这些结果也是相同的。结论 便秘与糖尿病患者患 DKD 的可能性较高有关，这表明临床评估便秘对于识别肾病进展高风险患者的重要性。
Background Constipation was shown to be associated with higher risk of end-stage kidney disease or incident chronic kidney disease, although evidence in diabetic patients is lacking. The objective of the present study was to examine the association between constipation and diabetic kidney disease (DKD). Methods In total, 4826 Japanese outpatients with type 2 diabetes were classified according to presence or absence of constipation (defecation frequency < 3 times/week and/or taking laxative medication). DKD was defined as presence of decreased estimated glomerular filtration rate (eGFR < 60 ml/min/1.73 m(2)), and/or albuminuria (urinary albumin-to-creatinine ratio >= 30 mg/g). Odds ratios for the presence of DKD were computed by a logistic regression model. Results Compared with participants without constipation, the age- and sex-adjusted odds ratio for presence of DKD was 1.58 (95% confidence interval 1.38-1.82) for those with constipation. This association persisted following adjustment for potential confounding factors. Decreased defecation frequency and laxative use were also significantly associated with higher prevalence of DKD. Overall, these findings were identical even when decreased eGFR and albuminuria were separately analyzed. Conclusions Constipation was associated with higher likelihood of DKD in patients with diabetes, suggesting the importance of clinical assessment of constipation to identify patients at high risk of progression of kidney disease.