Visit-to-visit lipid variability and adverse kidney events in real-world type 2 diabetes patients

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-03-10 DOI:10.1016/j.diabres.2025.112093

Hsuan-Yu Su , Yi-Hsin Chang , Chen-Yi Yang , Wei-Hung Lin , Huang-Tz Ou

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引用次数: 0

Abstract

Aim

To examine the association between long-term variability in low-density lipoprotein cholesterol (LDL-C) and the development of adverse kidney events among type 2 diabetes patients.

Methods

Kidney events of interest included sustained estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m², 30 % eGFR decline, and composite kidney events. The Cox proportional hazard model was used to assess the association between LDL-C variability and kidney events.

Results

A total of 15,444 patents were included (54 % male, mean age of 62.3 years, baseline HbA1c of 7.6 %, and eGFR of 84.2 mL/min/1.73 m²). The risk of kidney events increased with greater LDL-C variability across variability indices, except for that measured by coefficient of variation. Specifically, average real variability had the best predictive performance, with an optimal cut-off value of 19.26 for discriminating patients’ risk of a sustained eGFR < 15 mL/min/1.73 m². A greater effect of lipid variability on kidney event risk was observed among a subset of patients aged < 75 years, with eGFR ≥ 90 mL/min/1.73 m², or having fewer diabetes-related complications.

Conclusions

An increased risk of adverse kidney events with greater visit-to-visit variability in LDL-C highlights the clinical importance of monitoring both the single-point LDL-C and its stability over time.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.