José Antonio Gimeno-Orna1, Yolanda Blasco-Lamarca2, Belén Campos-Gutierrez3, Edmundo Molinero-Herguedas4, Luis Miguel Lou-Arnal5, Blanca García-García6. 1. Servicio de Endocrinología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. Electronic address: jagimeno@salud.aragon.es. 2. Servicio de Endocrinología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. 3. Servicio de Nefrología, Hospital Comarcal de Alcañiz, Alcañiz, Teruel, España. 4. Servicio de Cardiología, Hospital Universitario de Burgos, Burgos, España. 5. Servicio de Nefrología, Hospital Universitario Miguel Servet, Zaragoza, España. 6. Servicio de Endocrinología, Hospital Royo Villanova, Zaragoza, España.
Abstract
OBJECTIVE: Our aim was to assess the usefulness of glomerular filtration rate (GFR) and urinary albumin excretion (UAE) to predict the risk of mortality in patients with type 2 diabetes mellitus. MATERIAL AND METHODS: This is a prospective cohort study in patients with type 2 diabetes mellitus. Clinical end-point was mortality rate. GFR was measured in ml/min/1.73 m2 and stratified in 3 categories (≥60; 45-59; <45); UAE was measured in mg/24hours and was also stratified in 3 categories (<30; 30-300; >300). Mortality rates were reported per 1000 patient-years. Cox regression models were used to predict mortality risk associated with combined GFR and UAE. The predictive power was estimated with C-Harrell statistic. RESULTS: A total of 453 patients (39.3% males), aged 64.9 (SD 9.3) years were included; mean diabetes duration was 10.4 (SD 7.5) years. Median follow-up was 13 years. Total mortality rate was 39.5/1000. The progressive increase in mortality in the successive categories of GFR and UAE was statistically significant (P<.001). In a multivariable analysis, UAE (HR30-300=1.02 and HR>300=2.83; X2=11.6; P =.003) and GFR (HR45-59=1.34 and HR<45=1.84; X2=6.4; P =.041) were independent predictors for mortality, with no significant interaction. Simultaneous inclusion of GFR and UAE improved the predictive power of models (C-Harrell 0.741 vs. 0.726; P =.045). CONCLUSIONS: GFR and UAE are independent predictors for mortality in type 2 diabetic patients and do not show a statistically significant interaction.
OBJECTIVE: Our aim was to assess the usefulness of glomerular filtration rate (GFR) and urinary albumin excretion (UAE) to predict the risk of mortality in patients with type 2 diabetes mellitus. MATERIAL AND METHODS: This is a prospective cohort study in patients with type 2 diabetes mellitus. Clinical end-point was mortality rate. GFR was measured in ml/min/1.73 m2 and stratified in 3 categories (≥60; 45-59; <45); UAE was measured in mg/24hours and was also stratified in 3 categories (<30; 30-300; >300). Mortality rates were reported per 1000 patient-years. Cox regression models were used to predict mortality risk associated with combined GFR and UAE. The predictive power was estimated with C-Harrell statistic. RESULTS: A total of 453 patients (39.3% males), aged 64.9 (SD 9.3) years were included; mean diabetes duration was 10.4 (SD 7.5) years. Median follow-up was 13 years. Total mortality rate was 39.5/1000. The progressive increase in mortality in the successive categories of GFR and UAE was statistically significant (P<.001). In a multivariable analysis, UAE (HR30-300=1.02 and HR>300=2.83; X2=11.6; P =.003) and GFR (HR45-59=1.34 and HR<45=1.84; X2=6.4; P =.041) were independent predictors for mortality, with no significant interaction. Simultaneous inclusion of GFR and UAE improved the predictive power of models (C-Harrell 0.741 vs. 0.726; P =.045). CONCLUSIONS: GFR and UAE are independent predictors for mortality in type 2 diabeticpatients and do not show a statistically significant interaction.
Authors: John M Clements; Brady T West; Zachary Yaker; Breanna Lauinger; Deven McCullers; James Haubert; Mohammad Ali Tahboub; Gregory J Everett Journal: Diabetes Res Clin Pract Date: 2019-12-15 Impact factor: 5.602
Authors: María Marques; Paula López-Sánchez; Fernando Tornero; Pedro Gargantilla; Alba Maroto; Alberto Ortiz; José Portolés Journal: Clin Kidney J Date: 2022-04-14