在T2DM患者中开发和验证用于区分糖尿病病与非糖尿病病的预测性名录:一项多中心研究
Zishan Lin1,2,3, Tao Hong1,2,3, Wenfeng Wang1,2,3
1Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Frontiers in nutrition
|June 18, 2025
概括
一个新的非侵入性模型准确地区分了2型糖尿病 (T2DM) 患者的糖尿病病 (DN) 与非糖尿病病 (NDN),为改善治疗决策提供了侵入性活检的实用替代方案.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 诊断医学 诊断医学 诊断医学
背景情况:
- 2型糖尿病 (T2DM) 是一个主要的全球健康问题,糖尿病病 (DN) 是慢性病的主要原因.
- 区分DN与非糖尿病病 (NDN) 对T2DM患有病的患者至关重要,因为治疗途径不同.
- 脏活检,目前的黄金标准,是侵入性的,通常是不切实际的,强调了对非侵入性诊断方法的需求.
研究的目的:
- 开发和验证一种非侵入性诊断模型,用于在T2DM患者中区分DN和NDN.
- 确定可预测DN的关键临床和实验室参数.
- 创建一个实用的工具,用于在脏活检不可行的环境中临床使用.
主要方法:
- 一项多中心研究招募了292名接受脏活检的T2DM患者.
- 使用后勤回归分析,使用临床和实验室数据构建预测模型.
- 一个视觉预测名录图被构建并在一个独立的队列上验证.
主要成果:
- 该模型确定了糖尿病视网膜病变,糖尿病持续时间,HbA1c,静态血压,中性粒细胞与淋巴细胞的比例,体积,甘油三,估计的淋巴细胞过率和尿红细胞计数作为DN的独立预测因素.
- 开发的诺米图实现了高诊断准确性 (AUC = 0.941),验证证实其性能 (AUC = 0.923).
- 校准和决策曲线分析表明了良好的一致性和临床效用.
结论:
- 开发的非侵入性模型为脏活检提供了可靠的替代方案,用于在T2DM患者中区分DN和NDN.
- 这种工具在临床实践中特别有价值,用于指导适当的治疗策略,当活检是不切实际的.
- 该模型增强了诊断能力,有可能改善T2DM相关病患者的治疗结果.
相关概念视频
01:22Diabetes Mellitus: Type 2 and Gestational
3.0K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
3.0K
01:15Diabetes: Symptoms, Diagnosis, and Complications
715
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
715
01:28Chronic Kidney Disease III: Interprofessional Care
87
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
87
01:26Nephrotic Syndrome II : Assessment and Medical Management
26
IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
26
01:18Chronic Kidney Disease IV: Nursing Management
62
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
62
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
209
Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
209