Cargando…

The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18

OBJECTIVE: It is well known that diabetic kidney disease is a risk factor for cardiovascular diseases (CVD) in patients with type 2 diabetes mellitus (T2DM). In this study, the effects of urine albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR) on CVD outcomes were analyzed...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Xue-Lian, Yuan, Ming-Xia, Wan, Gang, Yang, Guang-Ran, Li, Dong-Mei, Fu, Han-Jing, Zhu, Liang-Xiang, Xie, Rong-Rong, Zhang, Jian-Dong, Lv, Yu-Jie, Li, Yu-Ling, Du, Xue-Ping, Wang, Zi-Ming, Cui, Xue-Li, Liu, De-Yuan, Gao, Ying, Cheng, Shu-Yan, Wang, Qian, Ji, Yu, Li, Guang-Wei, Yuan, Shen-Yuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124448/
https://www.ncbi.nlm.nih.gov/pubmed/30214217
http://dx.doi.org/10.2147/TCRM.S170915
_version_ 1783353028865163264
author Zhang, Xue-Lian
Yuan, Ming-Xia
Wan, Gang
Yang, Guang-Ran
Li, Dong-Mei
Fu, Han-Jing
Zhu, Liang-Xiang
Xie, Rong-Rong
Zhang, Jian-Dong
Lv, Yu-Jie
Li, Yu-Ling
Du, Xue-Ping
Wang, Zi-Ming
Cui, Xue-Li
Liu, De-Yuan
Gao, Ying
Cheng, Shu-Yan
Wang, Qian
Ji, Yu
Li, Guang-Wei
Yuan, Shen-Yuan
author_facet Zhang, Xue-Lian
Yuan, Ming-Xia
Wan, Gang
Yang, Guang-Ran
Li, Dong-Mei
Fu, Han-Jing
Zhu, Liang-Xiang
Xie, Rong-Rong
Zhang, Jian-Dong
Lv, Yu-Jie
Li, Yu-Ling
Du, Xue-Ping
Wang, Zi-Ming
Cui, Xue-Li
Liu, De-Yuan
Gao, Ying
Cheng, Shu-Yan
Wang, Qian
Ji, Yu
Li, Guang-Wei
Yuan, Shen-Yuan
author_sort Zhang, Xue-Lian
collection PubMed
description OBJECTIVE: It is well known that diabetic kidney disease is a risk factor for cardiovascular diseases (CVD) in patients with type 2 diabetes mellitus (T2DM). In this study, the effects of urine albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR) on CVD outcomes were analyzed in a population of T2DM. METHODS: The study was carried out using recorded information of a cohort study. A total of 1,914 patients with T2DM with no prevalent CVD were enrolled in an 8 years prospective study and received multifactorial intervention. The risk of CVD outcomes was assessed according to chronic kidney disease staging, which was categorized using AER (mg/d) and eGFR (mL/min/1.73 m(2)). The effects of AER and eGFR on risk of CVD onset were also analyzed. RESULTS: During the follow-up period (median 6.8 years), 71 CVD events occurred. At baseline, those with AER ≥300 mg/d and coexisting eGFR 60–89 mL/min/1.73 m(2) or <60 mL/min/1.73 m(2) showed increased risk for CVD outcomes when compared with “no chronic kidney disease” (AER <30 mg/d and eGFR ≥90 mL/min/1.73 m(2)). The increased CVD risk was observed in patients who progressed to AER ≥30 mg/d during the follow-up period, whereas patients who progressed to eGFR <90 mL/min/1.73 m(2) alone showed no increased CVD risk. During the follow-up period, after multifactorial intervention, 8.7% patients with microalbuminuria and 1.8% patients with overt nephropathy reversed to normoalbuminuria or microalbuminuria. CONCLUSION: AER is a more sensitive predictor than eGFR for CVD outcomes in T2DM patients. Overt nephropathy can be reversed after multifactorial intervention.
format Online
Article
Text
id pubmed-6124448
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-61244482018-09-13 The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18 Zhang, Xue-Lian Yuan, Ming-Xia Wan, Gang Yang, Guang-Ran Li, Dong-Mei Fu, Han-Jing Zhu, Liang-Xiang Xie, Rong-Rong Zhang, Jian-Dong Lv, Yu-Jie Li, Yu-Ling Du, Xue-Ping Wang, Zi-Ming Cui, Xue-Li Liu, De-Yuan Gao, Ying Cheng, Shu-Yan Wang, Qian Ji, Yu Li, Guang-Wei Yuan, Shen-Yuan Ther Clin Risk Manag Original Research OBJECTIVE: It is well known that diabetic kidney disease is a risk factor for cardiovascular diseases (CVD) in patients with type 2 diabetes mellitus (T2DM). In this study, the effects of urine albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR) on CVD outcomes were analyzed in a population of T2DM. METHODS: The study was carried out using recorded information of a cohort study. A total of 1,914 patients with T2DM with no prevalent CVD were enrolled in an 8 years prospective study and received multifactorial intervention. The risk of CVD outcomes was assessed according to chronic kidney disease staging, which was categorized using AER (mg/d) and eGFR (mL/min/1.73 m(2)). The effects of AER and eGFR on risk of CVD onset were also analyzed. RESULTS: During the follow-up period (median 6.8 years), 71 CVD events occurred. At baseline, those with AER ≥300 mg/d and coexisting eGFR 60–89 mL/min/1.73 m(2) or <60 mL/min/1.73 m(2) showed increased risk for CVD outcomes when compared with “no chronic kidney disease” (AER <30 mg/d and eGFR ≥90 mL/min/1.73 m(2)). The increased CVD risk was observed in patients who progressed to AER ≥30 mg/d during the follow-up period, whereas patients who progressed to eGFR <90 mL/min/1.73 m(2) alone showed no increased CVD risk. During the follow-up period, after multifactorial intervention, 8.7% patients with microalbuminuria and 1.8% patients with overt nephropathy reversed to normoalbuminuria or microalbuminuria. CONCLUSION: AER is a more sensitive predictor than eGFR for CVD outcomes in T2DM patients. Overt nephropathy can be reversed after multifactorial intervention. Dove Medical Press 2018-08-31 /pmc/articles/PMC6124448/ /pubmed/30214217 http://dx.doi.org/10.2147/TCRM.S170915 Text en © 2018 Zhang et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Zhang, Xue-Lian
Yuan, Ming-Xia
Wan, Gang
Yang, Guang-Ran
Li, Dong-Mei
Fu, Han-Jing
Zhu, Liang-Xiang
Xie, Rong-Rong
Zhang, Jian-Dong
Lv, Yu-Jie
Li, Yu-Ling
Du, Xue-Ping
Wang, Zi-Ming
Cui, Xue-Li
Liu, De-Yuan
Gao, Ying
Cheng, Shu-Yan
Wang, Qian
Ji, Yu
Li, Guang-Wei
Yuan, Shen-Yuan
The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18
title The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18
title_full The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18
title_fullStr The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18
title_full_unstemmed The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18
title_short The effects of AER and eGFR on outcomes of CVD in patients with T2DM in an urban community over 8 years of multifactorial treatment: the Beijing Communities Diabetes Study 18
title_sort effects of aer and egfr on outcomes of cvd in patients with t2dm in an urban community over 8 years of multifactorial treatment: the beijing communities diabetes study 18
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124448/
https://www.ncbi.nlm.nih.gov/pubmed/30214217
http://dx.doi.org/10.2147/TCRM.S170915
work_keys_str_mv AT zhangxuelian theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT yuanmingxia theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT wangang theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT yangguangran theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT lidongmei theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT fuhanjing theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT zhuliangxiang theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT xierongrong theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT zhangjiandong theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT lvyujie theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT liyuling theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT duxueping theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT wangziming theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT cuixueli theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT liudeyuan theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT gaoying theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT chengshuyan theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT wangqian theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT jiyu theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT liguangwei theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT yuanshenyuan theeffectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT zhangxuelian effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT yuanmingxia effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT wangang effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT yangguangran effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT lidongmei effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT fuhanjing effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT zhuliangxiang effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT xierongrong effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT zhangjiandong effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT lvyujie effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT liyuling effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT duxueping effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT wangziming effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT cuixueli effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT liudeyuan effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT gaoying effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT chengshuyan effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT wangqian effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT jiyu effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT liguangwei effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18
AT yuanshenyuan effectsofaerandegfronoutcomesofcvdinpatientswitht2dminanurbancommunityover8yearsofmultifactorialtreatmentthebeijingcommunitiesdiabetesstudy18