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首页> 外文期刊>BMC Nephrology >Risk of chronic kidney disease in young adults with impaired glucose tolerance/impaired fasting glucose: a retrospective cohort study using electronic primary care records
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Risk of chronic kidney disease in young adults with impaired glucose tolerance/impaired fasting glucose: a retrospective cohort study using electronic primary care records

机译：糖耐量受损/空腹血糖受损的青壮年患慢性肾脏疾病的风险：一项使用电子基层医疗记录的回顾性队列研究

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The risk of chronic kidney disease (CKD) is known to be elevated in patients with diabetes mellitus but the risk of young adults aged 18 to 40?years with impaired glucose tolerance/impaired fasting glucose (IGT/IFG) developing CKD is not well characterised. Furthermore, progression of IGT/IFG to diabetes and subsequent CKD development is not well understood. A retrospective cohort study was undertaken using The Health Improvement Network (THIN) database, a large dataset of electronic patient records. THIN database is jointly managed by IMS Health Real World Evidence Solution ( http://www.epic-uk.org/index.html ) and In Practice System (InPs). Cases were aged 18 to 40, with a diagnosis of IGT/IFG and registered at a practice contributing to THIN between 2000 and 2015. The study population consisted of 40,092 patients, including 21,454 (53.5%) female and 18,638 (46.5%) male. The median follow-up was approximately 2?years. The outcome was a diagnosis of CKD determined from either clinical coding or laboratory results. For the primary analysis the unadjusted and adjusted relative risk of CKD in IGT/IFG was compared to age, sex and practice matched controls with normoglycaemia. For the secondary analysis we compared the incidence of CKD before to after a diagnosis of type 2 diabetes (T2DM) in the IGT/IFG study cohort. The Incidence Rate Ratio (IRR) for CKD for IGT/IFG compared to normoglycaemia was 4.0 [95% confidence interval (CI), 3.2 to 5.1, P?
机译：已知患有糖尿病的患者会增加慢性肾脏疾病（CKD）的风险，但对糖耐量受损/空腹血糖受损（IGT / IFG）的18至40岁的年轻人发展为CKD的风险尚不明确。此外，人们对IGT / IFG向糖尿病的发展以及随后CKD的发展还知之甚少。使用健康改善网络（THIN）数据库进行了一项回顾性队列研究，该数据库是电子病历的大型数据集。 THIN数据库由IMS Health真实世界证据解决方案（http://www.epic-uk.org/index.html）和实践系统（InPs）共同管理。年龄在18至40岁之间，诊断为IGT / IFG，并在2000年至2015年期间在促成THIN的机构进行了注册。研究人群包括40,092名患者，其中21,454（53.5％）名女性和18,638（46.5％）名男性。中位随访时间约为2年。结果是根据临床编码或实验室结果确定的CKD诊断。对于初次分析，将IGT / IFG中未经调整和调整的CKD相对风险与年龄，性别和与正常血糖相匹配的对照组进行了比较。对于二级分析，我们比较了在IGT / IFG研究队列中诊断出2型糖尿病（T2DM）之前和之后CKD的发生率。与正常血糖相比，IGT / IFG的CKD发生率（IRR）为4.0 [95％置信区间（CI），3.2至5.1，P <0.001]。调整后的IRR为2.6 [95％CI，2.0至3.4，P <0.001。 IGT / IFG患者患上2型糖尿病后，未经调整的IRR为8.8 [95％CI，7.7至10.0，P 0.001]，而经过调整的IRR为6.3 [95％CI，5.5至7.2，P 0.001]。我们的结果表明，年轻的IGT / IFG受试者罹患CKD的风险也更高。基线肾脏功能和葡萄糖耐量的程度可调节这种风险，在发展为T2DM的人群中较高。

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