Association between renal function and diabetic retinopathy: a mediation analysis of geriatric nutritional risk index.

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetology & Metabolic Syndrome Pub Date : 2025-03-22 DOI:10.1186/s13098-025-01658-z

Youran Cai, Wanlu Qiu, Xiao Ma, Yuanting Yang, Ting Tang, Yuying Dong, Jian Chen, Qing Zhou

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Abstract

Background: Diabetes retinopathy (DR) is a prevalent microvascular complication of type 2 diabetes mellitus (T2DM). This study investigated the correlation between renal function and DR, as well as the potential mediating role of the geriatric nutritional risk index (GNRI).

Method: We classified 1122 adults with T2DM aged ≥ 40 years from the National Health and Nutrition Examination Survey database (2005-2008) into 2 groups: those with DR and those without DR. We used multivariate logistic regression analysis and restricted cubic spline (RCS) model to explore the relationship between renal function indicators and DR. Additionally, we analyzed the mediating impact of GNRI on renal function and DR.

Result: After accounting for all covariates, the weighted multivariate analysis revealed significant associations between renal function markers and DR. Specifically, creatinine, albumin, blood urea nitrogen, and serum uric acid to creatinine ratio (SUACr) were significantly correlated with DR in serum examination, while creatinine was the only marker correlated with DR in urine. GNRI was negatively correlated with DR (odds ratio 0.94, 95% CI 0.92-0.99). Weighted linear regression showed a negative association between SUACr and GNRI (β = 0.37; 95% CI 0.12-0.62). The RCS analysis showed a nonlinear association between serum creatinine and DR (P_non-linear = 0.013). GNRI mediated 14.4% of the relationship between SUACr and DR.

Conclusion: Our study adds to previous research by analyzing the associations between renal function indicators and DR. Furthermore, we highlight the mediating effect of GNRI, suggesting its potential utility as a predictive and treatment index for assessing renal function and DR.

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肾功能与糖尿病视网膜病变的关系：老年营养风险指数的中介分析。

背景：糖尿病视网膜病变（DR）是2型糖尿病（T2DM）常见的微血管并发症。本研究探讨了肾功能与DR的相关性，以及老年营养风险指数（GNRI）的潜在中介作用。方法：将全国健康与营养调查数据库（2005-2008）中1122例年龄≥40岁的T2DM患者分为有DR和无DR两组，采用多因素logistic回归分析和限制三次样条（RCS）模型探讨肾功能指标与DR的关系，并分析GNRI对肾功能和DR的中介作用。在考虑了所有协变量后，加权多变量分析显示肾功能指标与DR之间存在显著相关性，其中血清检查中肌酐、白蛋白、血尿素氮和血清尿酸/肌酐比（SUACr）与DR显著相关，而尿中肌酐是唯一与DR相关的指标。GNRI与DR呈负相关（优势比0.94,95% CI 0.92-0.99）。加权线性回归显示SUACr与GNRI呈负相关(β = 0.37；95% ci 0.12-0.62)。RCS分析显示血清肌酐与DR呈非线性相关（p非线性= 0.013）。结论：本研究在分析肾功能指标与DR之间关系的基础上，进一步强调了GNRI的中介作用，提示其作为评估肾功能和DR的预测和治疗指标的潜在应用价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-

CiteScore

6.20

自引率

0.00%

发文量

170

审稿时长

7.5 months

期刊介绍： Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.