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首页> 外文期刊>Therapeutic advances in endocrinology and metabolism. >Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function
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Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function

机译：使用胰岛素类似物（尤其是甘精胰岛素和赖脯胰岛素）进行的治疗可改善肾功能受损的1型糖尿病患者的肾功能和血红蛋白水平

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The influence of type of insulin treatment - insulin analogs versus human insulin - on the development of diabetes related vascular complications has been sparsely investigated. We examine here possible differences regarding kidney function and hemoglobin levels. Multiple linear regression was used to investigate the relationship between the following characteristics measured in 509 type 1 diabetic patients who were recruited in an outpatient practice: current clinical status and treatment modalities, type of injected insulin and the routine laboratory parameters hemoglobin, HbA1c, serum creatinine, eGFR, hs CRP and urinary albumin/creatinine ratio. Compared with human insulin, multiple regression analysis taking into account possible confounders revealed that treatment with insulin analogs was associated with increased eGFR (+7.1 ml/min; P=0.0002), lower urinary albumin/creatinine ratio (ratio logarithm -0.4; P=0.003) and higher hemoglobin concentration (+0.31 g/dl; P=0.04). Stratification by type of insulin showed the best renal status for treatment with insulins Glargine and Lispro. Differences were consistent both for patients with normal (eGFR → 90 ml/min) and with an impaired (eGFR ← 90 ml/min) kidney function. Present results suggest that treatment of type 1 diabetic patients with normal and impaired renal function with insulin analogs, especially Glargine and Lispro, is associated with better kidney function, lower urinary albumin/creatinine ratio and lower hemoglobin concentration compared to therapy with human insulin. If confirmed by other studies, treatment with insulin analogs may be a further possibility in delaying progression of nephropathy and in preventing early hemoglobin decline.
机译：稀疏研究了胰岛素治疗类型（胰岛素类似物与人胰岛素）对糖尿病相关血管并发症发生的影响。我们在这里检查关于肾功能和血红蛋白水平的可能差异。使用多元线性回归研究在门诊就诊的509位1型糖尿病患者中测量的以下特征之间的关系：当前的临床状况和治疗方式，注射的胰岛素类型以及常规实验室参数血红蛋白，HbA1c，血清肌酐，eGFR，hs CRP和尿白蛋白/肌酐比值。与人胰岛素相比，考虑到可能的混杂因素的多元回归分析表明，胰岛素类似物治疗与eGFR升高（+7.1 ml / min; P = 0.0002），尿白蛋白/肌酐比降低（对数比-0.4; P = 0.003）和更高的血红蛋白浓度（+0.31 g / dl; P = 0.04）。按胰岛素类型分层显示，使用甘精胰岛素和赖脯胰岛素治疗时，肾脏状况最佳。肾功能正常（eGFR→90 ml / min）和肾功能受损（eGFR←90 ml / min）的患者，差异均一致。目前的结果表明，与人胰岛素治疗相比，用胰岛素类似物（尤其是甘精胰岛素和赖脯胰岛素）治疗肾功能正常和肾功能不全的1型糖尿病患者与肾功能改善，尿白蛋白/肌酐比值降低和血红蛋白浓度降低有关。如果其他研究证实，则用胰岛素类似物治疗可能会进一步延缓肾病的进展并防止早期血红蛋白下降。

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