氧化平衡与糖尿病肾病和成人糖尿病患者死亡率相关：来自NHANES数据库和孟德尔随机化的见解

IF 3.2 3区医学

Journal of Diabetes Investigation Pub Date : 2024-12-26 DOI:10.1111/jdi.14390

Li Jiang, Jie Jian, Xulin Sai, Hongda Yu, Wanxian Liang, Xiai Wu

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引用次数: 0

摘要

目的：探讨并验证糖尿病患者氧化平衡与糖尿病肾病（DKD）患病率及死亡率之间的关系。研究设计：分析2013 - 2016年全国健康与营养调查（NHANES）中具有代表性的大样本，研究成人糖尿病患者氧化平衡评分（OBS）与DKD预后之间的潜在关联。采用加权多因素logistic回归分析检验OBS与DKD风险之间的关系。通过亚组分析、敏感性分析和中介效应分析来探讨协变量的影响并评估研究结果的稳健性。采用孟德尔随机化（Mendelian randomization， MR）在遗传水平上评估线粒体活性氧（reactive oxygen species， ROS）水平与DKD之间的相关关系。结果：与最低OBS四分位数相比，最高OBS四分位数与DKD呈最显著的负相关（OR = 0.62, 95% CI 0.41-0.92, P = 0.017）。较高的OBS与DKD风险降低相关(OR = 0.96；95% ci = 0.93, 0.98；结论：高水平的氧化平衡评分与糖尿病患者DKD风险和死亡率呈负相关。

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Oxidative balance is associated with diabetic kidney disease and mortality in adults with diabetes mellitus: Insights from NHANES database and Mendelian randomization.

Objective: To explore and validate the association between the oxidative balance and prevalence of diabetic kidney disease (DKD) and mortality in patients with diabetes.

Study design: A large and representative sample from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016 was analyzed to study the potential association between Oxidative Balance Score (OBS) and prognosis of DKD in adult diabetic patients. Weighted multivariate logistic regression analysis was conducted to examine the relationship between OBS and DKD risk. Subgroup analysis, sensitivity analysis, and mediation effect analysis were conducted to explore the effect of the covariates and assess the robustness of the findings. Mendelian randomization (MR) was employed to evaluate the correlated relationship between mitochondrial reactive oxygen species (ROS) levels and DKD at the genetic level.

Result: The highest OBS quartile showed the most significant negative correlation with DKD compared to the lowest OBS quartile (OR = 0.62, 95% CI 0.41-0.92, P = 0.017). Higher OBS was associated with a reduced risk of DKD (OR = 0.96; 95% CI = 0.93, 0.98; P < 0.001) and mortality (P = 0.021 by log-rank) in diabetic patients. This association remained robust even after excluding individual OBS components. Subgroup analysis revealed the interaction of metabolic syndrome on OBS was significant. Mediation analyses revealed that OBS's effect on DKD was independent of blood uric acid and cholesterol. Restricted cubic spline (RCS) analysis indicated a typical L-shaped relationship between OBS and DKD risk. The physical activity was identified as the core variable predicting DKD risk by two machine learning algorithms. MR showed a potential correlated relationship between ROS and microalbuminuria in DKD.

Conclusions: The high level of oxidative balance score was negatively correlated with the risk of DKD and mortality in diabetic patients.

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来源期刊

Journal of Diabetes Investigation Medicine-Internal Medicine

自引率

9.40%

发文量

218

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).