Open Access糖尿病或糖尿病前期患者中不同肾小球滤过率轨迹与心肌梗死风险的研究
Author(s) -
Zuo Yingting,
Wang Anxin,
Chen Shuohua,
Tian Xue,
Wu Shouling,
He Yan
Publication year - 2021
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13087
Subject(s) - medicine , prediabetes , myocardial infarction , hazard ratio , diabetes mellitus , proportional hazards model , prospective cohort study , type 2 diabetes , cardiology , endocrinology , confidence interval
Abstract Background The relationship between estimated glomerular filtration rate (eGFR) trajectories and myocardial infarction (MI) has so far been unclear in people with diabetes or prediabetes. We aimed to identify common eGFR trajectories in people with diabetes or prediabetes and to examine their association with MI risk. Methods The data of this analysis were derived from the Kailuan study, which was a prospective community‐based cohort study. The eGFR trajectories of 24 723 participants from the year 2006 to 2012 were generated by latent mixture modeling. Cox proportional hazards models were used to calculate hazard ratios (HR) and their 95% CI for the subsequent risk of MI of different eGFR trajectories. Results We identified five distinct eGFR trajectories during 2006 to 2012 and named them according to their eGFR range and pattern over time: low‐stable (9.4%), moderate‐stable (31.4%), moderate‐increasing (29.5%), high‐decreasing (13.9%), and high‐stable (15.8%). During a mean follow‐up of 4.61 years, there were a total of 235 incident MI. Although the high‐decreasing group had similar eGFR levels to the moderate‐stable group during the last exposure period, the risk was much higher (adjusted HR, 3.57; 95% CI, 1.63‐7.85 vs adjusted HR, 2.88; 95% CI, 1.36‐6.08). Notably, the moderate‐increasing group had reached the normal range, but still had a significantly increased risk (adjusted HR, 2.63; 95% CI, 1.24‐5.55). Conclusions eGFR trajectories were associated with MI risk in people with diabetes or prediabetes. These observations suggest that long‐term trajectories of eGFR may be important for risk prediction of MI and should be highlighted in primary prevention.