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震动感觉阈值与2型糖尿病患者慢性肾脏病的关系

Relationship between vibration perception threshold and chronic kidney disease in patients with type 2 diabetes mellitus

    摘要
  • 摘要:
    目的  探讨震动感觉阈值（VPT）与2型糖尿病（T2DM）患者慢性肾脏病（CKD）及其关键指标肾小球滤过率（eGFR）、尿微量白蛋白与肌酐比值（UACR）的相关性，旨在为T2DM患者慢性肾脏并发症找到早期、无创评估指标。
    方法  本研究纳入2023年1月至2023年10月期间惠州市中心人民医院（我国标准化代谢性疾病管理中心之一）就诊的1 825例确诊T2DM的患者资料。根据VPT水平的四分位数将其分为4组。收集其人口学特征及临床生化等指标，采用二元Logistic回归分析不同VPT水平与CKD、eGFR≤60 mL/（min•1.73 m2）和UACR≥30 mg/g的相关性。
    结果  T2DM总人群的CKD患病率为36.5%、蛋白尿患病率为33.5%。线性回归分析显示，VPT与eGFR≤60 mL/（min•1.73 m2）没有相关性（P = 0.054），但在把VPT按四分位数分为4组后，在多变量Logistic回归分析中，随着VPT水平的增加，eGFR逐渐降低，UACR逐渐升高。校正了年龄、性别、体质量指数、收缩压、舒张压、吸烟史、饮酒史、糖化血红蛋白、空腹胰岛素、尿酸、丙氨酸氨基转移酶、高血压、冠状动脉粥样硬化性心脏病、卒中和糖尿病周围血管病病史等混杂因素后，随着VPT水平的增加，eGFR≤60 mL/（min•1.73 m2）（OR = 1.28，P ＜ 0.0001）和 UACR≥30 mg/g（OR = 1.35，P ＜ 0.0001）的患病率均升高。
    结论  在中国T2DM患者中，VPT与CKD及蛋白尿的发生呈正相关，提示VPT或可作为评估糖尿病肾脏并发症风险的潜在无创指标。

     

    Abstract:
    Objective To investigate the correlation between vibration perception threshold (VPT) and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM), as well as its key indicators (estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR)), with the aim of identifying an early and non-invasive assessment indicator for chronic renal complications in T2DM patients.
    Methods This study included data from 1,825 patients with confirmed T2DM who visited Huizhou Central People's Hospital (one of the standardized management centers for metabolic diseases in China) between January 2023 and October 2023. Patients were divided into four groups according to the quartiles of VPT levels. Demographic characteristics and clinical biochemical indicators were collected. Binary logistic regression was used to analyze the correlation between different VPT levels and the occurrence of CKD, eGFR ≤60 mL/(min•1.73 m2), and UACR≥30 mg/g.
    Results In the overall diabetes population, the prevalence of CKD and proteinuria was 36.5% and 33.5%, respectively. Linear regression analysis showed no correlation between VPT and eGFR ≤60 mL/(min•1.73 m2) (P = 0.054). However, after dividing VPT into four quartile groups, multivariable logistic regression analysis demonstrated that, with increasing VPT levels, eGFR gradually decreased and UACR gradually increased. After adjustment for confounders, including age, gender, body mass index (BMI), systolic blood pressure, diastolic blood pressure, smoking history, alcohol consumption history, glycated hemoglobin, fasting insulin, uric acid (UA), alanine transaminase (ALT), and histories of hypertension, coronary atherosclerotic heart disease, stroke, and diabetic peripheral arterial disease (PAD), the prevalence of eGFR ≤60 mL/(min•1.73 m2) (OR = 1.28, P ＜ 0.0001) and UACR ≥30 mg/g (OR = 1.35, P ＜ 0.0001) was significantly increased with rising VPT levels.
    Conclusion Among Chinese patients with T2DM, VPT is positively correlated with the occurrence of CKD and proteinuria, suggesting that VPT may serve as a potential non-invasive indicator for assessing the risk of diabetic renal complications and is worthy of wider application in clinical screening.

     

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