基于Cox回归分析筛选2型糖尿病肾病发生的危险因素

An Analysis of Risk Factors for the Development of Type 2 DiabeticKidney Disease Based on Cox Regression Analysis

目的 筛选2型糖尿病肾病(diabetic kidney disease, DKD)发生的相关危险因素,为DKD早期干预提供理论依据。方法 回顾性收集2021年10月至2022年12月于首都医科大学附属北京世纪坛医院就诊住院的179例成年2型糖尿病患者的临床资料和实验室检查结果。通过单因素和多因素Cox回归分析方法筛选与DKD相关的危险因素,并分析其与患者胰岛功能的相关性。结果 DKD患者的血清白蛋白和估算肾小球滤过率水平显著低于T2DM不伴有肾脏损伤的患者,差异具有统计学意义(P<0.05)。DKD患者伴随糖尿病视网膜病变的概率远大于无肾脏损伤的患者,具有统计学意义(P<0.05)。多因素分析结果显示患者的年龄(HR=0.957,95%CI 0.928~0.987,P=0.006),体重指数(HR=1.084,95%CI 1.015~1.157,P=0.016)和糖化血红蛋白(HR=1.228,95%CI 1.074~1.403,P=0.003)为DKD发生的独立危险因素。此外,患者的体重指数和糖化血红蛋白与其胰岛功能存在一定相关性。结论 基于Cox回归分析方法,我们发现患者年龄、体重指数和糖化血红蛋白为DKD发生的独立危险因素,这为DKD的预防和治疗提供新的思路。

Objective To investigate the risk factors related to the development of type 2 diabetic kidney disease(DKD)and to provide a theoretical reference for the early prevention of DKD.Methods The clinical data and laboratory results were collected retrospectively from 179 adult patients with type 2 diabetes mellitus who were admitted to Beijing Shijitan Hospital,Capital Medical University,from October,2021 to December,2022.The risk factors related to the onset of DKD were identified by univariate and multifactorial Cox regression analysis,and the correlation between the screened indicators and patients’insulin function was analyzed.Results Serum albumin and estimated glomerular filtration rate levels were significantly lower in patients with DKD than in patients with T2DM without renal injury(P<0.05).Patients with DKD were more likely to develop diabetic retinopathy than diabetic patients without renal injury(P<0.05).Multifactorial analysis revealed that patients’age(HR=0.957,95%CI 0.928 to 0.987,P=0.006),BMI(HR=1.084,95%CI 1.015 to 1.157,P=0.016)and Glycohemoglobin(HR=1.228,95%CI 1.074 to 1.403,P=0.003)were independent risk factors for the development of DKD.In addition,there was a correlation between patients’BMI and glycohemoglobin,and patients’insulin function.Conclusion Based on Cox regression analysis,we found that patient age,BMI and glycohemoglobin are independent risk factors for the development of DKD,which provides novel insights to inform the prevention and treatment of DKD.