The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai
Objective To identify the risk factors for diabetic kidney disease (DKD) development, especially the difference between patients with different courses.Patients and methods 791 patients were considered to be eligible and were enrolled in the cross-sectional study from Shanghai Tongren Hospital Inpat...
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BMJ Publishing Group
2022-06-01
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| Online Access: | https://bmjopen.bmj.com/content/12/6/e060238.full |
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| author | Shan Huang Juan Du Nan Zhao Wen Liu Fan Hu Xiaoxu Ge Xiaohong Jiang Wenfang Peng Lisha Shen Lili Xia |
| author_facet | Shan Huang Juan Du Nan Zhao Wen Liu Fan Hu Xiaoxu Ge Xiaohong Jiang Wenfang Peng Lisha Shen Lili Xia |
| author_sort | Shan Huang |
| collection | DOAJ |
| description | Objective To identify the risk factors for diabetic kidney disease (DKD) development, especially the difference between patients with different courses.Patients and methods 791 patients were considered to be eligible and were enrolled in the cross-sectional study from Shanghai Tongren Hospital Inpatient Department. 36 variables were initially screened by univariate analysis. The risk factors affecting progression of DKD were determined by logistics regression analysis. Subgroups were grouped according to the course of diabetes disease, and multivariate logistics regression analysis was performed to find out the different risk factors in two subgroups. Finally, the receiver operating characteristics curve is used to verify the result.Results The logistic regression model indicated age (OR=1.020, p=0.017, 95% CI 1.004 to 1.040), systolic blood pressure (OR=1.013, p=0.006, 95% CI 1.004 to 1.022), waist circumference (OR=1.021, p=0.015, 95% CI 1.004 to 1.038), white blood cells (WBC, OR=1.185, p=0.001, 95% CI 1.085 to 1.295) and triglycerides (TG, OR=1.110, p=0.047, 95% CI 1.001 to 1.230) were risk factors for DKD, while free triiodothyronine (fT3, OR=0.711, p=0.011, 95% CI 0.547 to 0.926) was a protective factor for DKD in patients with type 2 diabetes mellitus (T2DM). Subgroup analysis revealed that in patients with a short duration of diabetes (<8 years), WBC (OR=1.306, p<0.001, 95% CI 1.157 to 1.475) and TG (OR=1.188, p=0.033, 95% CI 1.014 to 1.393) were risk factors for DKD,fT3 (OR=0.544, p=0.002, 95% CI 0.367 to 0.804) was a protective factor for DKD; whereas for patients with disease course more than 8 years, age (OR=1.026, Pp=0.012, 95%CI=95% CI[ 1.006– to 1.048]) was identified as the only risk factor for DKD and fT3 (OR=0.036, Pp=0.017, 95%CI=95% CI[ 0.439– to 0.922]) was a protective factor for DKD.Conclusion The focus of attention should especially be on patients with a prolonged course of T2DM, and those with comorbid hypertension and hypertriglyceridaemia waist phenotype. More potential clinical indexes such as thyroid function and inflammatory indicators might be considered as early warning factors for DKD in T2DM. Women should pay attention to controlling inflammation and TGs, and men should strictly control blood pressure. Avoiding abdominal obesity in both men and women will bring great benefits. |
| format | Article |
| id | doaj-art-00496a4b22dd46a891bb51caaf226c0d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
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| spelling | doaj-art-00496a4b22dd46a891bb51caaf226c0d2025-01-24T16:25:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-060238The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in ShanghaiShan Huang0Juan Du1Nan Zhao2Wen Liu3Fan Hu4Xiaoxu Ge5Xiaohong Jiang6Wenfang Peng7Lisha Shen8Lili Xia98 College of Animal Science, Jilin University, Changchun, China2 Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, ChinaTongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China5 Department of Neurology, Yan`an University Xianyang Hospital, Xianyang, China1 School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaTongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, ChinaTongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, ChinaTongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, ChinaTongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, ChinaTongren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, ChinaObjective To identify the risk factors for diabetic kidney disease (DKD) development, especially the difference between patients with different courses.Patients and methods 791 patients were considered to be eligible and were enrolled in the cross-sectional study from Shanghai Tongren Hospital Inpatient Department. 36 variables were initially screened by univariate analysis. The risk factors affecting progression of DKD were determined by logistics regression analysis. Subgroups were grouped according to the course of diabetes disease, and multivariate logistics regression analysis was performed to find out the different risk factors in two subgroups. Finally, the receiver operating characteristics curve is used to verify the result.Results The logistic regression model indicated age (OR=1.020, p=0.017, 95% CI 1.004 to 1.040), systolic blood pressure (OR=1.013, p=0.006, 95% CI 1.004 to 1.022), waist circumference (OR=1.021, p=0.015, 95% CI 1.004 to 1.038), white blood cells (WBC, OR=1.185, p=0.001, 95% CI 1.085 to 1.295) and triglycerides (TG, OR=1.110, p=0.047, 95% CI 1.001 to 1.230) were risk factors for DKD, while free triiodothyronine (fT3, OR=0.711, p=0.011, 95% CI 0.547 to 0.926) was a protective factor for DKD in patients with type 2 diabetes mellitus (T2DM). Subgroup analysis revealed that in patients with a short duration of diabetes (<8 years), WBC (OR=1.306, p<0.001, 95% CI 1.157 to 1.475) and TG (OR=1.188, p=0.033, 95% CI 1.014 to 1.393) were risk factors for DKD,fT3 (OR=0.544, p=0.002, 95% CI 0.367 to 0.804) was a protective factor for DKD; whereas for patients with disease course more than 8 years, age (OR=1.026, Pp=0.012, 95%CI=95% CI[ 1.006– to 1.048]) was identified as the only risk factor for DKD and fT3 (OR=0.036, Pp=0.017, 95%CI=95% CI[ 0.439– to 0.922]) was a protective factor for DKD.Conclusion The focus of attention should especially be on patients with a prolonged course of T2DM, and those with comorbid hypertension and hypertriglyceridaemia waist phenotype. More potential clinical indexes such as thyroid function and inflammatory indicators might be considered as early warning factors for DKD in T2DM. Women should pay attention to controlling inflammation and TGs, and men should strictly control blood pressure. Avoiding abdominal obesity in both men and women will bring great benefits.https://bmjopen.bmj.com/content/12/6/e060238.full |
| spellingShingle | Shan Huang Juan Du Nan Zhao Wen Liu Fan Hu Xiaoxu Ge Xiaohong Jiang Wenfang Peng Lisha Shen Lili Xia The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai BMJ Open |
| title | The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai |
| title_full | The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai |
| title_fullStr | The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai |
| title_full_unstemmed | The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai |
| title_short | The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai |
| title_sort | analysis of risk factors for diabetic kidney disease progression a single centre and cross sectional experiment in shanghai |
| url | https://bmjopen.bmj.com/content/12/6/e060238.full |
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