定量评估 2 型糖尿病患者的代谢记忆及其对肾功能衰退的预测：回顾性观察研究

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews Pub Date : 2025-04-01 DOI:10.1016/j.dsx.2025.103225

Kentaro Oniki , Takuro Shigaki , Ayami Kajiwara-Morita , Keiichi Shigetome , Akira Yoshida , Hideaki Jinnouchi , Junji Saruwatari

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引用次数: 0

摘要

目的：本研究通过模拟2型糖尿病（T2D）患者高血糖暴露与肾功能下降之间的关系，定量评估代谢记忆。方法对381例日本T2D患者进行回顾性纵向研究。通过计算观察期间HbA1c≥6% （AUCHbA1c≥6%）的曲线下面积（AUC）来表示高血糖暴露。建立非线性混合效应模型，以AUCHbA1c≥6%为基础预测肾小球滤过率（eGFR）的变化。结果AUCHbA1c≥6%与eGFR变化呈s型曲线关系，协变量包括性别、年龄、糖尿病视网膜病变、血脂异常和高血压。使用拟合优度图、视觉预测检查和自举方法验证了模型的预测效用。我们建立了一个基于AUCHbA1c≥6%的模型来预测T2D患者的肾功能下降，表明AUCHbA1c≥6%可以作为代谢记忆的定量指标。

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Quantitative assessment of metabolic memory and its prediction of renal function decline in patients with type 2 diabetes: A retrospective observational study

Aims

This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).

Methods

This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUC_{HbA1c ≥ 6 %}) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUC_{HbA1c ≥ 6 %}.

Results

The relationship between AUC_{HbA1c ≥ 6 %} and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.

Conclusions

We developed an AUC_{HbA1c ≥ 6 %}-based model to predict renal function decline in patients with T2D, showing that AUC_{HbA1c ≥ 6 %} may serve as a quantitative indicator of metabolic memory.

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来源期刊

Diabetes & Metabolic Syndrome-Clinical Research & Reviews ENDOCRINOLOGY & METABOLISM-

CiteScore

22.90

自引率

2.00%

发文量

248

审稿时长

51 days

期刊介绍： Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care. Types of Publications: Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.