2型糖尿病患者中CKD进展的种族差异和快速EGFR下降:二次数据分析
Thamer Alobaid1, Matthew D L O'Connell2, Janaka Karalliedde3
1School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK. thamer.alobaid@kcl.ac.uk.
BMC nephrology
|July 2, 2025
概括
患有2型糖尿病和慢性病的非白人个体经历了更快的功能下降. 糖尿病视网膜病变加剧了这种进展,特别是在黑人人口中,需要量身定制的干预措施.
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.
- 公共卫生 公共卫生
背景情况:
- 患有2型糖尿病 (T2DM) 和慢性病 (CKD) 的患者表现出不同的功能下降率.
- 关于种族和糖尿病视网膜病变如何影响估计的淋巴细胞过率 (eGFR) 降低和CKD进展的数据有限.
研究的目的:
- 调查种族和糖尿病视网膜病变对T2DM队列中EGFR下降和CKD进展的影响.
- 在不同种族群体中识别不同的eGFR轨迹.
主要方法:
- 从2004年至2018年,对14489名T2DM患者的分析,基线eGFR≥45毫升/分钟/1.73米2.
- 使用基于组的轨迹模型 (GBTM) 用于eGFR轨迹识别.
- 采用多项物流模型来评估CKD在快速衰退者中进展到第4和第5阶段.
主要成果:
- 每个种族群体分别确定了四个不同的eGFR轨迹.
- 最快的eGFR下降率 (≥1.92毫升/分钟/年) 是年龄较大,ACR较高,基线eGFR较低.
- 与白人相比,非白人族群的CKD进展相对风险比率明显高;糖尿病视网膜病变与更快的进展有关,特别是在黑人患者中.
结论:
- 非白人种族在T2DM中面临加速CKD进展,糖尿病视网膜病变是显著的贡献因素,特别是在黑人个体中.
- 调查结果强调需要文化定制的预防和干预策略,以减轻CKD结果差异.
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