基于肾小球滤过率轨迹的2型糖尿病患者肾功能降低快速进展危险因素分析及与胰岛素抵抗的相关性  

Risk factors for rapid renal function progression in patients with type 2 diabetes mellitus and its correlation with insulin resistance based on eGFR trajectory

作　　者：杨琦 潘锦婷 刘妍[1] 赵少俐[2] 易斌[1] YANG Qi;PAN Jinting;LIU Yan(Department of Nephrology,The Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院肾内科,长沙410013 [2]中南大学湘雅三医院内分泌科,长沙410013

出　　处：《中国糖尿病杂志》2023年第8期571-575,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(82070759);湖南省自然科学基金(2021JJ31032)。

摘　　要：目的探讨T2DM患者肾功能降低快速进展的危险因素及与IR的相关性。方法选取2009年1月至2017年12月于中南大学湘雅三医院内分泌科就诊的T2DM患者733例,根据eGFR组基轨迹建模分组,通过Logistic回归分析评估eGFR快速降低的危险因素及与IR的关系。结果733例T2DM患者中201例(27.4%)出现eGFR快速降低。Logistic回归分析显示,年龄、DM病程及胰岛素抵抗指数(HOMA-IR)是T2DM患者eGFR快速降低的危险因素。合并IR患者eGFR快速降低风险升高52%。结论年龄、DM病程、HOMA-IR是T2DM患者eGFR快速降低的危险因素,T2DM合并IR者更易发生肾功能快速降低。Objective To investigate the risk factors of rapid renal function progression and its relationship with insulin resistance(IR)in patients with type 2 diabetes mellitus(T2DM).Methods The data of T2DM patients who first visited the Third Xiangya Hospital of Central South University from January 2009 to December 2017 were collected and grouped by Group-based trajectory model of estimate glomerular filtration rate(eGFR).Logistic regression was used to explore the risk factors of rapid decline in eGFR and its relationship with IR.Results Among 733 T2DM patients,201(27.4%)had a rapid decline in eGFR.Logistic regression showed that age,disease duration,homeostasis assessment model of insulin resistance(HOMA-IR)were independent risk factors for rapid decline of eGFR in T2DM patients.Patients with IR had a 52%higher risk of rapid eGFR decline than those without IR.Conclusion Age,disease duration and HOMA-IR were independent risk factors for rapid decline of eGFR in T2DM patients.Rapid renal function progression was more likely to occur in T2DM patients with HOMA-IR.

关 键 词：胰岛素抵抗 肾功能快速降低 糖尿病 2型 组基轨迹建模 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]