Remnant cholesterol and the risk of diabetic nephropathy progression to end-stage kidney disease in patients with type 2 diabetes mellitus: a longitudinal cohort study

作者：Yuancheng Zhao, Ke Liu, Yutong Zou, Yucheng Wu, Jia Yang, Xiang Xiao, Xuegui Ju, Qin Yang, Yanlin Lang, Fang Liu · 发表于：Endocrine · 年份：2024 · DOI：10.1007/s12020-024-03948-4 · 被引用次数：8 · 研究领域：Chronic Kidney Disease and Diabetes、Renal Diseases and Glomerulopathies、Diabetes Treatment and Management

Abstract Aim Diabetic nephropathy (DN) is the most common cause of end-stage kidney disease (ESKD). Remnant cholesterol has been investigated as a predictor for the progression of DN in type 1 diabetes mellitus patients, as well as the incidence of DN in type 2 diabetes mellitus (T2DM) patients. This study aimed to evaluate the longitudinal relationship between baseline remnant cholesterol and kidney outcomes using a Chinese T2DM with biopsy-confirmed DN cohort. Methods We included 334 patients with T2DM and biopsy-confirmed DN during 2010–2019 West China Hospital T2DM-DN cohort. Remnant cholesterol was defined by Martin-Hopkins equation. Patients were divided into four groups based on the median (IQR) remnant cholesterol concentration at the time of renal biopsy. The kidney outcome was defined as ESKD, which was defined as the need for chronic kidney replacement therapy or estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m 2 . The relationship between remnant cholesterol and kidney outcome was analyzed using the Kaplan‒Meier method and Cox regression analysis. Results The mean age was 51.1 years, and 235 (70%) were men. During follow-up, a total of 121 (36.2%) patients reached ESKD. The Kaplan‒Meier analysis showed that patients in the highest quartile (quartile 4) group had lower cumulative renal survival (log-rank test, p = 0.033) and shorter median renal survival time [34.0 (26.4–41.6) vs. 55.0 (29.8–80.2) months] than patients in the lowest quartile (quart...