Single and joint impact of type 2 diabetes and of congestive heart failure on albuminuria,Journal of Diabetes and its Complications

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Single and joint impact of type 2 diabetes and of congestive heart failure on albuminuria
Journal of Diabetes and its Complications ( IF 3 ) Pub Date : 2021-09-12 , DOI: 10.1016/j.jdiacomp.2021.108046
Christoph H Saely ₁ , Maximilian Maechler ₁ , Alexander Vonbank ₁ , Lukas Sprenger ₁ , Arthur Mader ₁ , Barbara Larcher ₁ , Daniela Zanolin-Purin ₂ , Andreas Leiherer ₃ , Axel Muendlein ₃ , Heinz Drexel ₄

Affiliation

Aims

Albuminuria is a characteristic feature of diabetic nephropathy, and urine albumin excretion is also increased in patients with congestive heart failure (CHF). However, no data are available on the single and joint associations of type 2 diabetes mellitus (T2DM) and CHF with albuminuria. This issue was addressed in the present study.

Methods

We investigated 4 groups of patients: 180 patients with CHF, of whom 83 had T2DM (CHF+/T2DM+) and 97 did not have diabetes (CHF+/T2DM-) and 223 controls without CHF, of whom 39 had T2DM (CHF-/T2DM+) and 184 did not have diabetes (CHF-/T2DM-).

Results

The albumin-creatinine ratio (ACR) was 9.2 [5.7–16.9] mg/g in CHF-/T2DM- patients. Compared to this group it was higher in CHF-/T2DM+ patients (16.1 [7.7–27.8] mg/g; p = 0.004), in CHF+/T2DM- patients (22.0 [9.0–76.8] mg/g; p < 0.001) and in CHF+/T2DM+ patients (66.2 [16.0–177.0] mg/g; p < 0.001), in whom in turn it was higher than in CHF-/T2DM+ (p < 0.001) or in CHF+/T2DM- (p = 0.001) patients. The ACR did not differ significantly between CHF-/T2DM+ and CHF+/T2DM- patients (p = 0.188). In multivariate analysis of covariance, CHF and T2DM proved to be independent predictors of ACR after multivariate adjustment (F = 5.68; p = 0.018 and F = 4.79; p = 0.029, respectively).

Conclusions

We conclude that T2DM and CHF are mutually independent determinants of albuminuria.

中文翻译：

2 型糖尿病和充血性心力衰竭对蛋白尿的单一和联合影响

目标

白蛋白尿是糖尿病肾病的特征，在充血性心力衰竭 (CHF) 患者中，尿白蛋白排泄量也会增加。然而，没有关于 2 型糖尿病 (T2DM) 和 CHF 与白蛋白尿的单一和联合关联的数据。本研究解决了这个问题。

方法

我们调查了 4 组患者：180 名 CHF 患者，其中 83 名患有 T2DM（CHF+/T2DM+），97 名没有糖尿病（CHF+/T2DM-）和 223 名没有 CHF 的对照，其中 39 名患有 T2DM（CHF-/T2DM+ ) 和 184 人没有糖尿病 (CHF-/T2DM-)。

结果

CHF-/T2DM- 患者的白蛋白-肌酐比 (ACR) 为 9.2 [5.7–16.9] mg/g。与该组相比，CHF-/T2DM+ 患者 (16.1 [7.7–27.8] mg/g; p = 0.004) 在 CHF+/T2DM- 患者中更高 (22.0 [9.0–76.8] mg/g; p < 0.001)而在 CHF+/T2DM+ 患者中（66.2 [16.0–177.0] mg/g；p < 0.001），依次高于 CHF-/T2DM+（p <0.001）或 CHF+/T2DM-（p = 0.001））耐心。CHF-/T2DM+ 和 CHF+/T2DM- 患者的 ACR 没有显着差异 ( p = 0.188)。在协方差的多变量分析中，经多变量调整后，CHF 和 T2DM 被证明是 ACR 的独立预测因子（F = 5.68；p = 0.018 和 F = 4.79；p = 0.029，分别）。