糖尿病脏病患者血糖变化和功能进展之间的关系:一项回顾性队列研究
Ling Yang1, Bo Zhou2, Rensheng Deng3
1Endocrinology Department, The Lichuan Ethnic Hospital of Traditional Chinese Medicine, Lichuan City, Hubei Province, China.
Medicine
|February 3, 2026
概括
高血糖变化 (GV) 在糖尿病病 (DKD) 患者中显著增加不良结局的风险. 监测GV可以帮助个性化糖尿病管理并减缓疾病的进展.
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.
- 代谢疾病 代谢疾病
背景情况:
- 糖尿病病 (DKD) 是末期病的主要原因.
- 虽然慢性高血糖是已知的因素,但血糖变异性 (GV) 在DKD进展中的作用尚未完全理解.
研究的目的:
- 调查GV在DKD患者的预后意义.
- 为了确定GV是否可以独立预测脏不良结果和功能下降的速度.
主要方法:
- 一项对156名DKD患者的回顾性队列研究,随访时间中位数为36个月.
- 根据变化系数评估GV;患者分为四分位数.
- 主要终点:≥40%的eGFR下降,ESRD或与脏相关的死亡的复合;使用Cox回归和混合效应模型进行分析.
主要成果:
- 与最低四分位数相比,最高的GV四分位数显示事件的发生率明显更高 (43.6%对12.8%).
- 增加的GV (每1个SD增加CV) 与22-30%的不良结果风险增加有关 (P<0.05).
- 证实了GV和加速的eGFR下降之间的剂量反应关系.
结论:
- 在DKD患者中,更高的血糖变异性是不良结局和更快的eGFR下降的独立预测因素.
- GV评估可能会提高DKD的风险分层.
- 包括GV在内的个性化血糖管理可能有助于延缓DKD的进展.
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