Diabetes, Hypertension, and Incidence of Chronic Kidney Disease: Is There any Multiplicative or Additive Interaction?

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

International Journal of Endocrinology and Metabolism Pub Date : 2020-11-02 eCollection Date: 2021-01-01 DOI:10.5812/ijem.101061

Saeed Erfanpoor, Koorosh Etemad, Sara Kazempour, Farzad Hadaegh, Jalil Hasani, Fereidoun Azizi, Donna Parizadeh, Davood Khalili

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引用次数: 21

Abstract

Background: The burden of chronic kidney disease (CKD) is on the rise worldwide; diabetes and hypertension are mentioned as the main contributors.

Objectives: The current study aimed to investigate the multiplicative and additive interaction of diabetes and hypertension in the incidence of CKD.

Methods: In this population-based cohort study, 7342 subjects aged 20 years or above (46.8% male) were divided into four groups: no diabetes and hypertension; diabetes and no hypertension; hypertension and no diabetes; and both diabetes and hypertension. The multivariable Cox regression was used to determine the effect of diabetes, hypertension, and their multiplicative interaction on CKD. The following indices were used to determine the additive interaction of diabetes and hypertension: the relative excess risk of interaction, the attributable proportion due to interaction, and the synergism index.

Results: Diabetes and hypertension had no significant multiplicative interaction in men (hazard ratio of 0.93, P value: 0.764) and women (hazard ratio of 0.79, P value: 0.198); furthermore, no additive interaction was found in men (relative excess risk due to interaction of 0.79, P value: 0.199; attributable proportion due to interaction of 0.22, P value: 0.130; synergy index of 1.44, P value: 0.183) and women (relative excess risk due to interaction of -0.26, P value: 0.233, attributable proportion due to interaction of -0.21, P value: 0.266; synergy index of 0.48, P value: 0.254).

Conclusions: This study demonstrated no synergic effect between diabetes and hypertension on the incidence of CKD.

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糖尿病、高血压和慢性肾脏疾病的发病率:是否存在乘法或加法的相互作用?

背景:慢性肾脏疾病(CKD)的负担在世界范围内呈上升趋势;糖尿病和高血压被认为是主要诱因。目的:本研究旨在探讨糖尿病和高血压在CKD发病率中的倍增性和叠加性相互作用。方法:在这项以人群为基础的队列研究中，7342名年龄在20岁及以上的受试者(46.8%为男性)分为四组:无糖尿病和高血压;糖尿病，无高血压;高血压，无糖尿病;还有糖尿病和高血压。使用多变量Cox回归来确定糖尿病、高血压及其乘法相互作用对CKD的影响。采用以下指标确定糖尿病与高血压的加性相互作用:相互作用的相对过量风险、相互作用的归因比例和协同作用指数。结果:糖尿病与高血压在男性(危险比0.93,P值:0.764)和女性(危险比0.79,P值:0.198)中无显著的乘法相互作用;此外，在男性中未发现加性相互作用(相互作用导致的相对过量风险为0.79,P值:0.199;交互作用归因比例为0.22,P值为0.130;协同指数为1.44,P值为0.183)和女性(相互作用导致的相对超额风险为-0.26,P值为0.233，相互作用导致的可归因比例为-0.21,P值为0.266;协同指数为0.48,P值为0.254)。结论:本研究表明糖尿病和高血压对慢性肾病的发病率没有协同作用。

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来源期刊

International Journal of Endocrinology and Metabolism ENDOCRINOLOGY & METABOLISM-

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： The aim of the International Journal of Endocrinology and Metabolism (IJEM) is to increase knowledge, stimulate research in the field of endocrinology, and promote better management of patients with endocrinological disorders. To achieve this goal, the journal publishes original research papers on human, animal and cell culture studies relevant to endocrinology.