文章摘要
心脏代谢指数与2型糖尿病肾脏病的相关性研究
Association between cardiometabolic index and diabetic kidney disease in patients with type 2 diabetes mellitus
投稿时间:2022-09-04  
DOI:10.3969/j.issn.1000-0399.2023.05.006
中文关键词: 糖尿病肾病  心脏代谢指数  尿白蛋白/肌酐比值
英文关键词: Diabetic kidney disease  Cardiometabolic index  Urinary albumin/creatinine ratio
基金项目:南京市医学科技发展项目(编号:YKK21089)
作者单位E-mail
袁芳 210008 江苏 南京 南京医科大学鼓楼临床医学院肾内科  
李楠 210008 江苏 南京 南京大学医学院附属鼓楼医院肾内科  
张庆燕 210008 江苏 南京 南京大学医学院附属鼓楼医院肾内科  
刘晶 210008 江苏 南京 南京大学医学院附属鼓楼医院肾内科  
鲁荐 210008 江苏 南京 南京大学医学院附属鼓楼医院肾内科  
陈楚儿 210008 江苏 南京 南京中医药大学鼓楼临床医学院肾内科  
蒋春明 210008 江苏 南京 南京大学医学院附属鼓楼医院肾内科  
王恒进 210008 江苏 南京 南京医科大学鼓楼临床医学院肾内科
210008 江苏 南京 南京大学医学院附属鼓楼医院肾内科 
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中文摘要:
      目的 探讨 2 型糖尿病(T2DM)患者心脏代谢指数(CMI)与糖尿病肾脏病(DKD)的相关性。方法 选择 2018 年 2 月至 2022 年 7 月在南京鼓楼医院就诊且被诊断为 T2DM 的 173 例患者,根据是否合并 DKD,分为单纯 T2DM 组(n=89)和 DKD 组(n=84)。比较两组患者临床资料的差异,采用二元 logistic 回归分析 DKD 的风险因素,通过受试者工作特征(ROC)曲线评估 CMI 对发生 DKD 的预测价值。结果 两组患者糖尿病病程、身体质量指数、腰围、腰高比、收缩压(SBP)、舒张压、空腹血浆血糖、糖化血红蛋白(HbA1c)、CMI、血尿酸(SUA)差异均有统计学意义(P<0.05)。二元 logistic 回归分析显示,SBP(OR=1.042,95%CI:1.020~1.066)、糖尿病病程(OR=1.110,95%CI:1.047~1.176)、HbA1c(OR=1.434,95%CI:1.183~1.738)、CMI(OR=5.069,95%CI:2.254~11.401)、SUA(OR=1.005,95%CI:1.000~1.010)是 DKD 发生的危险因素(均 P<0.05)。ROC 曲线结果显示,CMI 的曲线下面积为 0.794,最佳截断点为 0.529 时,灵敏度为 0.910,特异度为 0.619。结论 CMI 是 T2DM 患者 DKD 发生的危险因素,对 DKD 的发生具有较高的预测价值。
英文摘要:
      Objective To explore the association between cardiometabolic index(CMI) anddiabetic kidney disease(DKD) in patients with type 2 diabetes mellitus(T2DM). Methods A total of 173 patients diagnosed as T2DM in Nanjing Drum Tower Hospital from February 2018 to July 2022 were selected.According to whether they had combined DKD,they were divided into simple T2DM group(n=89)and DKD group(n=84). The clinical data were retrospectively analyzed,and cardiometabolic index was calculated.The differences between the two groups were compared by t test,Mann-Whitney U test or χ2 test.The risk factors of DKD were analyzed by binary logistic regression analysis.The predictive value of CMI for DKD was evaluated by the receiver operating characteristic(ROC) curve. Results Course of diabetes,body mass index,waist circumference,waist-to-height ratio,systolic blood pressure(SBP),diastolic blood pressure,fasting plasma glucose,glycosylated hemoglobin(HbA1c), CMI and serum uric acid (SUA)were statistically different between the two groups(all P<0.05). Binary logistic regression analysis indicated SBP (OR=1.042,95%CI:1.020~1.066),course of diabetes (OR=1.110,95%CI:1.047~1.176),HbA1c(OR=1.434,95%CI:1.183~1.738), CMI (OR=5.069, 95%CI:2.254~11.401) and SUA(OR=1.005, 95%CI:1.000~1.010) were risk factors influencing the incidence of DKD (all P< 0.05).The ROC curve indicated that the area under the curve of cardiometabolic index was 0.794.When the cut-off value of cardiometabolic index was 0.529,the sensitivity of diagnosis was 0.910,and the specificity was 0.619. Conclusion CMI is arisk factor influencing the incidence of DKD in patients with T2DM,which has high predicting value for DKD.
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