在患有2型糖尿病的成年人中估计的淋巴膜过率变化和发生心力衰竭的概率
Arnaud D Kaze1, Chiadi E Ndumele2, Bernard G Jaar3
1Division of Cardiology, Department of Medicine, Banner-University Medical Center Phoenix, The University of Arizona College of Medicine, Phoenix, Arizona, USA.
JACC. Advances
|July 11, 2025
概括
估计较高的淋巴膜过率 (eGFR) 变化与2型糖尿病患者心力衰竭风险增加有关. 这一发现突显了功能波动作为心血管事件的关键预测因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 估计的淋巴细胞过率 (eGFR) 变化是心血管结果的潜在风险因素.
- 在2型糖尿病 (T2D) 患者中,eGFR变异性和发作性心力衰竭 (HF) 之间的关联尚未得到充分证实.
研究的目的:
- 在一大批T2D患者中,研究eGFR变异性与发生性HF之间的关联.
- 为了确定功能波动是否预测这个人群中HF的发展.
主要方法:
- 在ACCORD研究中利用了7,601名参与者的数据,在24个月内测量了≥5个eGFR.
- 使用变化系数 (CV),标准偏差 (SD) 和独立于平均值的可变性评估了eGFR的可变性.
- 采用Cox的比例危险模型来计算事件HF的调整危险比率 (HR).
主要成果:
- 193名参与者在3年的中位数随访期间发展出HF.
- 随着eGFR变量的四分位数的增加,HF发病率上升.
- 高GFR CV的最高四分位数与HF风险增加1.88倍相关 (HR:1.88;95% CI:1.09-3.22).
- 每个eGFR变化指标 (CV,SD,独立于平均值的变化) 的1-SD增加都与更高的HF风险相关.
结论:
- 升高的eGFR可变性是T2D成年人发生HF的独立预测因素.
- 功能变化在这个患者群体中代表了心力衰竭的重要危险因素.
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