尿转铁蛋白与2型糖尿病人群新发心血管疾病的关系

Association of urinary transferrin with new-onset cardiovascular disease in type 2 diabetes mellitus

目的探索2型糖尿病(type 2 diabetes mellitus,T2DM)人群尿转铁蛋白与尿肌酐比值(uTRF/Cr)和新发心血管疾病(cardiovascular disease,CVD)的关系。方法选择参加开滦第6次健康体检且进行尿转铁蛋白及尿肌酐检测的T2DM患者8163例。依据基线uTRF/Cr水平将患者按三分位数分为3组,第一分位组2721例,第二分位组2721例;第三分位组2721例。采用多因素Cox回归模型分析uTRF/Cr对CVD发病风险的影响。结果①研究人群基线年龄(60.46±9.96)岁,男性占78.30%,基线uTRF/Cr为0.24(0.16~0.47)mg/mmol。②中位随访时间为3.85(3.43~4.22)年,共发生CVD事件411例(6.79%),第一、二、三分位组总CVD事件的累计发病率分别为3.81%、4.65%和7.29%。③校正相关影响因素后,第二、三分位组总CVD事件的风险分别是第一分位组的1.12(95%CI:0.86~1.46)倍和1.52(95%CI:1.18~1.97)倍。结论uTRF/Cr升高是T2DM人群CVD的独立危险因素,在出现大量白蛋白尿之前,CVD的发病风险也随着uTRF/Cr升高而增加。

Objective To explore the correlation between urinary transferrin to urinary creatinine ratio(uTRF/Cr)and new onset cardiovascular disease(CVD)in type 2 diabetes mellitus(T2DM).Methods A total of 8163 T2DM patients who participated in the 6th health examination in Kailuan and underwent urinary transferrin and urinary creatinine detection were recruited.Subjects were divided into the first group(n=2721),the second group(n=2721),and the third group(n=2721)based on baseline uTRF/Cr.The effects of uTRF/Cr on the risk of CVD were analyzed by multivariate Cox regression model.Results The baseline age of the study population was(60.46±9.96)years,with 78.30%of males,and 0.24(0.16-0.47)mg/mmol of baseline uTRF/Cr.The median follow-up time was 3.85(3.43-4.22)years,with 411(6.79%)of CVD events occurred.The cumulative incidence of total CVD events in the first,second and third groups was 3.81%,4.65%,and 7.29%,respectively.After adjusting for relevant influencing factors,the risk of total CVD events in the second and third groups of uTRF/Cr was 1.12(95%CI 0.86-1.46)times and 1.52(95%CI 1.18-1.97)times that in the first group,respectively.Conclusion Increased uTRF/Cr is an independent risk factor for CVD in T2DM populations,and the risk of CVD increases with increased uTRF/Cr,even before the onset of macroalbuminuria.