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首页> 外文期刊>Journal of Diabetes and Metabolic Disorders >Direct association of visit-to-visit HbA1c variation with annual decline in estimated glomerular filtration rate in patients with type 2 diabetes
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Direct association of visit-to-visit HbA1c variation with annual decline in estimated glomerular filtration rate in patients with type 2 diabetes

机译：2型糖尿病患者访视HbA1c变异与估计肾小球滤过率逐年下降的直接关系

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Background/Aims This study examined associations of visit-to-visit variability of glycemic control with annual decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes attending an outpatient clinic. Methods Intrapersonal mean and coefficient of variation (CV) of 8-12 measurements of HbA1c and those of 4-6 measurements of fasting and post-breakfast plasma glucose (FPG and PPG, respectively) during the first 12 months after enrollment were calculated in a cohort of 168 patients with type 2 diabetes. Annual changes in eGFR were computed using 52 (median) creatinine measurements obtained over a median follow-up of 6.0 years. Multivariate linear regressions assessed the independent correlates of changes in eGFR. Results CV-HbA1c (standardized β、-0.257、p?=?0.004) were significantly and log urine albumin/creatinine ratio (standardized β、-0.155、p?=?0.085) and smoking (standardized β、-0.186、p?=?0.062) tended to be associated with annual eGFR decline independently of mean HbA1c, age, sex, BMI, waist circumference, diabetes duration and therapy, means and CVs of FPG, PPG and systolic blood pressure, baseline eGFR, and uses of anti-hypertensive and lipid-lowering medications. Association between HbA1c variability and renal function decline was stronger in patients with albumin/creatinine ratio ≧ 30 mg/g than in those with normoalbuminuria (r?=?-0.400, p?=?0.003 and r?=?-0.169, p?=?0.07, respectively). Conclusions Consistency of glycemic control is important to preserve kidney function in type 2 diabetic patients, in particular, in those with nephropathy.
机译：背景/目的本研究调查了门诊就诊的2型糖尿病患者的血糖控制访视变异性与估计肾小球滤过率（eGFR）年度下降之间的关系。方法在入选后的前12个月中计算HbA1c的8-12次测量的人内均值和变异系数（CV），空腹和早餐后血糖（分别为FPG和PPG）的4-6次测量的人内平均值和变异系数（CV）。 168例2型糖尿病患者。 eGFR的年度变化是通过在6.0年的中位随访期内获得的52次（中值）肌酐测量值计算得出的。多元线性回归评估了eGFR变化的独立相关性。结果CV-HbA1c（标准β，-0.257，p？= 0.004）显着，对数尿白蛋白/肌酐比值（标准β，-0.155，p？= 0.085）和吸烟（标准β，-0.186，p？ = 0.062）往往与年度eGFR下降相关，而与平均HbA1c，年龄，性别，BMI，腰围，糖尿病持续时间和治疗方法，FPG，PPG和收缩压的均值和CV，基线eGFR以及抗-降压和降脂药物。白蛋白/肌酐比≥30 mg / g的患者的HbA1c变异性与肾功能下降之间的联系比正常白蛋白尿的患者更强（r = = 0.400，p = 0.003，r = = -0.169，p≥分别等于？0.07）。结论血糖控制的一致性对于维持2型糖尿病患者（尤其是肾病患者）的肾功能至关重要。

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