Association between admission hemoglobin level and prognosis in patients with type 2 diabetes mellitus  

作　　者：Hai-Ying Song Cui-Mei Wei Wen-Xiong Zhou Hao-Fei Hu Qi-Jun Wan 

机构地区：[1]Department of Nephrology,The First Affiliated Hospital of Shenzhen University,Shenzhen Second People’s Hospital,Shenzhen 518035,Guangdong Province,China [2]Department of Nephrology,Shenzhen University Health Science Center,Shenzhen 518035,Guangdong Province,China

出　　处：《World Journal of Diabetes》2021年第11期1917-1927,共11页世界糖尿病杂志（英文版）（电子版）

基　　金：the Research Project of Health and Family Planning Commission of Shenzhen Municipality,No.SZFZ2018063;Shenzhen Key Medical Discipline Construction Fund,No.SZXK009;Sanming Project of Medicine in Shenzhen,No.SZSM201512004;and Shenzhen Second People’s Hospital Clinical Research Fund of Guangdong Province High-level Hospital Construction Project,No.20203357003 and No.20213357018.

摘　　要：BACKGROUND Anaemia is common in patients with chronic kidney disease(CKD)and is a major risk factor that contributes to mortality in such patients.Type 2 diabetes mellitus(T2DM)is one of the leading causes of CKD.The association between admission hemoglobin levels and renal damage in patients with T2DM remains unclear.AIM To evaluate the relationship between admission hemoglobin levels and prognosis in patients with T2DM.METHODS We performed a retrospective analysis of 265 consecutive patients presenting with T2DM between 2011 and 2015.The composite endpoint was end-stage renal disease or a 50%reduction in the estimated glomerular filtration rate.RESULTS In multivariable-adjusted Cox proportional hazards models(adjusting for demographic factors,traditional risk factors,lipids),the adjusted hazard ratios(HRs)for the highest and middle tertiles compared to the lowest tertile of hemoglobin were 0.82(95%CI:0.11-6.26,P=0.8457)and 0.28(95%CI:0.09-0.85,P=0.0246),respectively.However,after further adjustment for glycaemia control,hemoglobin was positively related to the risk of the composite endpoint(HR:1.05,95%CI:0.14-8.09,P=0.9602)when the highest tertile was compared to the lowest tertile of hemoglobin.We found a U-shaped relationship between hemoglobin levels and the composite endpoint.The curve tended to reach the lowest level at an optimal hemoglobin level.CONCLUSION Among patients with T2DM,a U-shaped relationship was observed between hemoglobin levels and renal damage.A lower admission hemoglobin level(hemoglobin<13.3 g/dL)is an independent predictor of renal damage.

关 键 词：Type 2 diabetes mellitus HEMOGLOBIN Renal damage PROGNOSIS 

分 类 号：R587.1[医药卫生—内分泌]