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首页> 外文期刊>Diabetic medicine: A journal of the British Diabetic Association >Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study
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Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study

机译：性别调节成纤维细胞生长因子21与亚洲人患有2型糖尿病的末期肾病的关联：一个6.3年的前瞻性队列研究

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Abstract Aim To study whether plasma fibroblast growth factor 21 independently predicts the risk of end‐stage renal disease in Asian people with Type 2 diabetes. Methods In this prospective cohort study, 1700 Asian people with Type 2 diabetes were followed for a mean of 6.3 years in a regional hospital in Singapore. Incident end‐stage renal disease was identified by linkage with a national renal registry. The association of baseline fibroblast growth factor 21 levels with risk of progression to end‐stage renal disease was studied using survival analyses. Results Participants were aged 60 ± 10 years, with an average diabetes duration of 12 years. Their estimated GFR was 73 ± 28 ml/min/1.73 m 2 and 62% had albuminuria at baseline. A total of 179 incident end‐stage renal disease cases were identified. Plasma fibroblast growth factor 21 interacted with sex in its association with end‐stage renal disease ( P interaction = 0.003). A 1‐ sd increment in fibroblast growth factor 21 (natural log‐transformed) was associated with a 1.32‐fold (95% CI 1.05–1.66, P = 0.02) increased hazard for end‐stage renal disease in women, after adjustment for traditional risk factors including estimated GFR and albuminuria. Taking death as a competing risk did not materially change the outcome [sub‐distribution hazard ratio 1.35 (95% CI 1.11–1.66, P = 0.003)]. Fibroblast growth factor 21 did not predict end‐stage renal disease risk in men after adjustment for baseline estimated GFR and albuminuria [hazard ratio 1.07 (95% CI 0.89–1.28, P = 0.49)]. Conclusions Plasma fibroblast growth factor 21 level independently predicted risk of progression to end‐stage renal disease in women with Type 2 diabetes. The pathophysiological relationships among FGF 21, sex and renal progression warrant further study.
机译：摘要目的研究亚洲2型糖尿病患者血浆成纤维细胞生长因子21是否独立预测终末期肾病的风险。方法在这项前瞻性队列研究中，在新加坡一家地区性医院对1700名亚洲2型糖尿病患者进行了平均6.3年的随访。通过与国家肾脏登记处的联系，确定了偶发终末期肾病。使用生存分析研究了基线成纤维细胞生长因子21水平与进展为终末期肾病风险的相关性。结果受试者年龄60±10岁，平均糖尿病病程12年。他们估计的GFR为73±28 ml/min/1.73 m2，62%的人在基线检查时有蛋白尿。共发现179例终末期肾病病例。血浆成纤维细胞生长因子21与性别相互作用，与终末期肾病相关（P相互作用=0.003）。在调整传统风险因素（包括估计的GFR和蛋白尿）后，成纤维细胞生长因子21（自然对数转化）的1-sd增量与女性终末期肾病风险增加1.32倍（95%可信区间1.05–1.66，P=0.02）相关。将死亡视为一种竞争风险并没有实质性改变结果[次级分布危险比1.35（95%可信区间1.11–1.66，P=0.003）]。在校正基线估计的GFR和蛋白尿后，成纤维细胞生长因子21不能预测男性终末期肾病风险[危险比1.07（95%可信区间0.89–1.28，P=0.49）]。结论血浆成纤维细胞生长因子21水平独立预测2型糖尿病女性进展为终末期肾病的风险。FGF 21、性别和肾脏进展之间的病理生理关系值得进一步研究。

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