摘要
目的通过巢式病例对照研究, 探讨纤维蛋白原/白蛋白比值(FAR)与2型糖尿病(T2DM)肾脏疾病进展的相关性以及预测价值。方法选取2019年4月至2022年8月于天津医科大学朱宪彝纪念医院肾病内科住院治疗的T2DM伴微量白蛋白尿患者228例为研究对象, 收集基线资料、随访资料。中位随访时间25.43(17.18, 37.65)个月。依据患者的肾病是否进展将其分为进展组(n=98)和未进展组(n=130), 评估FAR与T2DM肾脏疾病进展的相关性。结果进展组尿白蛋白/肌酐比值(UACR)、估算的肾小球滤过率(eGFR)年下降率、FAR高于未进展组(P均<0.05)。Spearman相关性分析结果显示, FAR与T2DM肾脏疾病进展呈正相关(r=0.222, P<0.05)。高FAR是T2DM肾脏疾病进展的独立危险因素(OR=1.220, 95%CI:1.040~1.433, P=0.015)。受试者工作特征(ROC)曲线显示, FAR预测T2DM肾脏疾病进展的曲线下面积为0.630(95%CI:0.557~0.702, P=0.001)。体重指数(BMI)分层回归分析显示, 肥胖患者中, 较高水平的FAR与肾脏疾病进展的相关性更为显著(OR=1.332, 95%CI:1.008~1.761, P=0.044)。结论 FAR与T2DM患者的肾脏疾病进展密切相关, 肥胖患者更显著。FAR可成为预测T2DM肾脏疾病进展的指标。
Objective To explore the correlation and predictive value of the fibrinogen/albumin ratio(FAR)with the progression of kidney disease in type 2 diabetes mellitus(T2DM)through a nested casecontrol study.Methods A total of 228 T2DM patients with microalbuminuria admitted to the Department of Nephrology,Chu Hsien-I Memorial Hospital of Tianjin Medical University from April 2019 to August 2022 were selected.Baseline and follow-up data were collected.The median follow-up time was 25.43(17.18,37.65)months.Patients were divided into the progressive group(n=98)and the non-progression group(n=130)according to whether their kidney diseases progressed,and the correlation between FAR and the progression of kidney disease in T2DM was evaluated.Results The annual decline rate and FAR of urine albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR)in the progressive group were higher than those in the non-progressive group(all P<0.05).Spearman correlation showed that FAR(r=0.222,P<0.05)was positively correlated with the progression of T2DM nephropathy.High FAR was an independent risk factor for progression of kidney disease in T2DM(OR=1.220,95%CI:1.040-1.433,P=0.015).The receiver operating characteristic(ROC)curve pltting showed that the area under the curve of FAR in predicting the progression of renal disease in T2DM was 0.630(95%CI:0.557-0.702,P=0.001).Stratified regression analysis of body mass index(BMI)showed that higher levels of FAR were more significantly associated with kidney disease progression in obese patients(OR=1.332,95%Cl:1.008-1.761,P=0.044).Conclusion FAR is strongly associated with kidney disease progression in T2DM patients,and more significantly in obese patients.FAR can be used as an indicator to predict the progression of kidney disease in type 2 diabetes mellitus.
作者
王珊珊
郑羽彤
范伊霓
孙蓓
单春艳
Wang Shanshan;Zheng Yutong;Fan Yini;Sun Bei;Shan Chunyan(Tianjin Medical University Chu Hsien-I Memorial Hospital,Tianjin Institute of Endocrinology,NHC Key Lab of Hormones and Development,Tianjin Key Lab of Metabolic Diseases,Tianjin 300134,China)
出处
《国际内分泌代谢杂志》
2025年第4期226-231,共6页
International Journal of Endocrinology and Metabolism
基金
天津市教委科研计划项目(2020KJ189)。
