国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Changes in proteinuria and the risk of myocardial infarction in people with diabetes or pre‑diabetes: a prospective cohort study

第一作者:Anxin Wang,Yang Sun

通讯作者:Shouling Wu,Xiuhua Guo

Myocardial infarction Proteinuria Diabetes Pre-dia

基本信息

2017-08-15

已发表文章

发表杂志:Cardiovasc Diabetol

发表类型: Original Contributions

影响因子(IF): 9.951

PMID: 28927413 Pubmed原文链接 全文下载

主要研究背景及目的

The relationship between changes in proteinuria and myocardial infarction (MI) remains unclear in people with diabetes or pre-diabetes. We aimed to evaluate the predictive value and independent role of changes in proteinuria over a 2-year period in the incidence of MI in people with diabetes or pre-diabetes.

方法

Based on the baseline and 2-year dipstick screening results from the Kailuan prospective cohort study, participants were divided into four categories: no proteinuria, remittent proteinuria, incident proteinuria, and persistent proteinuria. Four multivariable Cox proportional hazard models were built to adjust for the effects of different confounding covariates.

结论

Persistent proteinuria is an independent risk factor for MI incidence in the pre-diabetic and diabetic population. These findings may help clinicians to interpret proteinuria changes in the outpatient setting and provide possible preventive approaches for people with pre-diabetes or diabetes.

主要结果

Among the 17,625 participants in this study, there were a total of 238 incidents of MI during a median follow-up of 6.69 years. After adjusting for demography factors and laboratory indices, the association between persistent proteinuria and MI incidence was maintained (hazard ratio [HR] 2.50, 95% confidence interval [CI] 1.48–4.22). Every decrease of proteinuria from 2006 to 2008 was observed to be responsible for a 21% decline of MI incidence (HR 0.79, 95% CI 0.68–0.90). The interaction between changes in proteinuria and diabetes was confirmed with no effect on MI (P = 0.3371).