{"title":"成人糖尿病患者中基于胱抑素C和肌酐的肾小球滤过率和糖尿病相关多病风险的差异","authors":"Fei Chen , Yang Zhang , Darui Gao , Yanyu Zhang , Shengguo Yi , Jingcui Guo , Ying Gao , Wuxiang Xie","doi":"10.1016/j.diabres.2025.112419","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the association of discrepancies between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) with incident diabetes-related multimorbidity.</div></div><div><h3>Methods</h3><div>This longitudinal cohort study included 21,938 UK Biobank participants with diabetes and free of diabetes-related microvascular or macrovascular disease at baseline. eGFRdiff was calculated as both the absolute difference (eGFRabdiff) and the relative difference (eGFRrediff). Primary outcome was the incidence of any multimorbidity. Secondary outcomes included microvascular-macrovascular, microvascular, and macrovascular multimorbidity. Cox proportional hazard regression models were used to evaluate the associations between eGFRdiff and the outcomes.</div></div><div><h3>Results</h3><div>Over a median follow-up of 12.5 years, there were 2,252 cases of any multimorbidity, 1,554 cases of microvascular-macrovascular multimorbidity, 792 cases of microvascular multimorbidity, and 642 cases of macrovascular multimorbidity. Each 10 mL/min/1.73 m<sup>2</sup> decrease in eGFRabdiff was associated with 23 %, 22 %, 32 % and 23 % higher risk of any multimorbidity, microvascular-macrovascular multimorbidity, microvascular multimorbidity, and macrovascular multimorbidity, respectively. Similarly, each 10 % decrease in eGFRrediff corresponded to increase the risk of outcomes. Subgroups analyses yielded consistent results.</div></div><div><h3>Conclusions</h3><div>Lower eGFRdiff values were independently associated with elevated diabetes-related multimorbidity risks. These findings suggest that monitoring eGFRdiff in individuals with diabetes could aid in identifying patients with high-risk multimorbidity and potentially improve clinical outcomes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112419"},"PeriodicalIF":7.4000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Difference between cystatin C- and creatinine-based estimated glomerular filtration rate and risk of diabetes-related multimorbidity among adults with diabetes\",\"authors\":\"Fei Chen , Yang Zhang , Darui Gao , Yanyu Zhang , Shengguo Yi , Jingcui Guo , Ying Gao , Wuxiang Xie\",\"doi\":\"10.1016/j.diabres.2025.112419\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><div>To evaluate the association of discrepancies between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) with incident diabetes-related multimorbidity.</div></div><div><h3>Methods</h3><div>This longitudinal cohort study included 21,938 UK Biobank participants with diabetes and free of diabetes-related microvascular or macrovascular disease at baseline. eGFRdiff was calculated as both the absolute difference (eGFRabdiff) and the relative difference (eGFRrediff). Primary outcome was the incidence of any multimorbidity. Secondary outcomes included microvascular-macrovascular, microvascular, and macrovascular multimorbidity. Cox proportional hazard regression models were used to evaluate the associations between eGFRdiff and the outcomes.</div></div><div><h3>Results</h3><div>Over a median follow-up of 12.5 years, there were 2,252 cases of any multimorbidity, 1,554 cases of microvascular-macrovascular multimorbidity, 792 cases of microvascular multimorbidity, and 642 cases of macrovascular multimorbidity. Each 10 mL/min/1.73 m<sup>2</sup> decrease in eGFRabdiff was associated with 23 %, 22 %, 32 % and 23 % higher risk of any multimorbidity, microvascular-macrovascular multimorbidity, microvascular multimorbidity, and macrovascular multimorbidity, respectively. Similarly, each 10 % decrease in eGFRrediff corresponded to increase the risk of outcomes. Subgroups analyses yielded consistent results.</div></div><div><h3>Conclusions</h3><div>Lower eGFRdiff values were independently associated with elevated diabetes-related multimorbidity risks. These findings suggest that monitoring eGFRdiff in individuals with diabetes could aid in identifying patients with high-risk multimorbidity and potentially improve clinical outcomes.</div></div>\",\"PeriodicalId\":11249,\"journal\":{\"name\":\"Diabetes research and clinical practice\",\"volume\":\"227 \",\"pages\":\"Article 112419\"},\"PeriodicalIF\":7.4000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes research and clinical practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0168822725004334\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes research and clinical practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0168822725004334","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Difference between cystatin C- and creatinine-based estimated glomerular filtration rate and risk of diabetes-related multimorbidity among adults with diabetes
Aims
To evaluate the association of discrepancies between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) with incident diabetes-related multimorbidity.
Methods
This longitudinal cohort study included 21,938 UK Biobank participants with diabetes and free of diabetes-related microvascular or macrovascular disease at baseline. eGFRdiff was calculated as both the absolute difference (eGFRabdiff) and the relative difference (eGFRrediff). Primary outcome was the incidence of any multimorbidity. Secondary outcomes included microvascular-macrovascular, microvascular, and macrovascular multimorbidity. Cox proportional hazard regression models were used to evaluate the associations between eGFRdiff and the outcomes.
Results
Over a median follow-up of 12.5 years, there were 2,252 cases of any multimorbidity, 1,554 cases of microvascular-macrovascular multimorbidity, 792 cases of microvascular multimorbidity, and 642 cases of macrovascular multimorbidity. Each 10 mL/min/1.73 m2 decrease in eGFRabdiff was associated with 23 %, 22 %, 32 % and 23 % higher risk of any multimorbidity, microvascular-macrovascular multimorbidity, microvascular multimorbidity, and macrovascular multimorbidity, respectively. Similarly, each 10 % decrease in eGFRrediff corresponded to increase the risk of outcomes. Subgroups analyses yielded consistent results.
Conclusions
Lower eGFRdiff values were independently associated with elevated diabetes-related multimorbidity risks. These findings suggest that monitoring eGFRdiff in individuals with diabetes could aid in identifying patients with high-risk multimorbidity and potentially improve clinical outcomes.
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.