Diabetes Care：青年2型糖尿病患者肾脏不良转归危险升高
2012-03-31 MedSci MedSci原创
3月19日，《糖尿病护理》杂志（Diabetes care）发表的加拿大学者的一项研究表明，2型糖尿病青年患者的不良肾脏转归和死亡风险均升高；蛋白尿和肾素-血管紧张素-醛固酮系统抑制剂应用与成年早期转归不佳相关。（Diabetes care.2012-03-19） 此项研究共纳入342例2型糖尿病青年患者、1011例2型糖尿病青年患者以及1710例对照者，并利用ICD编码对远期转归进行评估。
3月19日，《糖尿病护理》杂志（Diabetes care）发表的加拿大学者的一项研究表明，2型糖尿病青年患者的不良肾脏转归和死亡风险均升高；蛋白尿和肾素-血管紧张素-醛固酮系统抑制剂应用与成年早期转归不佳相关。（Diabetes care.2012-03-19）
此项研究共纳入342例2型糖尿病青年患者、1011例2型糖尿病青年患者以及1710例对照者，并利用ICD编码对远期转归进行评估。
结果显示，与1型糖尿病青年患者相比，2型糖尿病青年患者的肾衰风险升高4倍。与肾衰相关的危险因素为肾素-血管紧张素-醛固酮系统抑制剂应用和青春期蛋白尿。与年龄、性别和地域相匹配的对照者相比，2型糖尿病青年患者的肾衰风险升高23倍，透析风险升高39倍。2型和1型糖尿病组的10年时Kaplan-Meier生存率分别为91.4%和99.5%（P<0.0001）。两组10年时肾脏生存率均为100%。15和20年时2型糖尿病组分别降低至92.0%和55.0%，但1型糖尿病组保持稳定（P<0.0001）。
High Burden of Kidney Disease in Youth-Onset Type 2 Diabetes
Allison B. Dart, Elizabeth A. Sellers, Patricia J. Martens, Claudio Rigatto, Marni D. Brownell, and Heather J. Dean
Abstract： OBJECTIVETo evaluate renal outcomes and survival in youth with type 2 diabetes versus type 1 diabetes versus nondiabetic control subjects.RESEARCH DESIGN AND METHODSIn total, 342 prevalent youth (aged 1-18 years) with type 2 diabetes, 1,011 youth with type 1 diabetes, and 1,710 control subjects iden... OBJECTIVETo evaluate renal outcomes and survival in youth with type 2 diabetes versus type 1 diabetes versus nondiabetic control subjects.RESEARCH DESIGN AND METHODSIn total, 342 prevalent youth (aged 1-18 years) with type 2 diabetes, 1,011 youth with type 1 diabetes, and 1,710 control subjects identified from 1986 to 2007 were anonymously linked to health care records housed at the Manitoba Centre for Health Policy to assess long-term outcomes using ICD codes.RESULTSYouth with type 2 diabetes were found to have a fourfold increased risk of renal failure versus youth with type 1 diabetes. Risk factors associated with renal failure were renin angiotensin aldosterone system inhibitor use and albuminuria in adolescence. Compared with control subjects (age, sex, and postal code matched), youth with type 2 diabetes had a 23-fold increased risk of renal failure and a 39-fold increased risk of dialysis. Kaplan-Meier survival at 10 years was 91.4% in the type 2 diabetic group versus 99.5% in the type 1 diabetic group (P < 0.0001). Renal survival was 100% at 10 years in both groups. It decreased to 92.0% at 15 years and 55.0% at 20 years in the type 2 diabetic group but remained stable in the type 1 diabetic group (P < 0.0001).CONCLUSIONSYouth with type 2 diabetes are at high risk of adverse renal outcomes and death. Albuminuria and angiotensin aldosterone system inhibitor use, which may be a marker of severity of disease, are associated with poor outcomes in early adulthood.
作者：MedSci
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