Bone mineral density and the risk of kidney disease in patients with type 1 diabetes.

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM Journal of diabetes and its complications Pub Date : 2024-12-05 DOI:10.1016/j.jdiacomp.2024.108927

Sabina Chaudhary Hauge, Henrik Øder Hjortkjær, Frederik Persson, Simone Theilade, Morten Frost, Niklas Rye Jørgensen, Peter Rossing, Ditte Hansen

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Abstract

Aim: To explore the association between bone disorder and the risk for progression of diabetic kidney disease (DKD) in persons with type 1 diabetes mellitus (T1DM).

Methods: In this prospective cohort study the association between bone mineral density (BMD), bone-derived factors (sclerostin, Dickkopf-1, and osteoprotegerin (OPG)), and four outcomes were investigated: 1) progression of albuminuria; 2) decline in estimated glomerular filtration rate (eGFR) ≥30 %; 3) kidney failure (KF); and 4) a composite kidney outcome consisting of at least one of the outcomes.

Results: In 318 participants (median follow-up time 5.5 years) patients with osteoporosis (BMD with T-score < -2.5) had increased risk of eGFR decline: hazard ratio (HR) 2.56 (95 % CI 1.06-6.19, p = 0.04), KF: HR 9.92 (95 % CI 1.16-84.95, p = 0.04), and the composite kidney outcome: HR 2.42 (95 % CI 1.18-4.96, p = 0.02). Patients with high OPG had increased risk of eGFR decline, KF, and the composite outcome, compared to patients with low OPG in unadjusted analysis. No bone-derived factor was associated with any outcome in adjusted analyses.

Conclusions: In patients with T1DM low BMD was associated with progression of DKD, suggesting an interaction between bone and kidney.

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骨密度与1型糖尿病患者肾脏疾病的风险

目的：探讨1型糖尿病（T1DM）患者骨紊乱与糖尿病肾病（DKD）进展风险的关系。方法：在这项前瞻性队列研究中，研究了骨密度（BMD）、骨源性因子（硬化蛋白、Dickkopf-1和骨保护素（OPG））与四个结局之间的关系：1)蛋白尿的进展；2)估计肾小球滤过率（eGFR）下降≥30%；3)肾衰竭（KF）；以及4)由至少一种结果组成的复合肾脏结局。结论：在T1DM患者中，低BMD与DKD进展相关，提示骨和肾之间存在相互作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.