Unstably controlled systolic blood pressure trajectories are associated with markers for kidney damage in prediabetic population: results from the INDEED cohort study

Journal of Translational Medicine

Kevin He¹  Shou-Ling Wu²  Shuo-Hua Chen³  Hui-Fen Zhang⁴  Dong-Yuan Chang⁵  Ming-Hui Zhao⁵  Jin-Wei Wang⁵  Zi-Jun Sun⁵  Min Chen⁵  Lu-Xia Zhang⁵ 

[1] Department of Biostatistics, School of Public Health, University of Michigan;Department of Cardiology, Kailuan General Hospital Affiliated to North China University of Science and Technology;Health Care Center of Kailuan Group;Laboratory Department of Kailuan General Hospital;Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education;

关键词: Blood pressure;    Estimated glomerular filtration rate;    Kidney damage;    Prediabetes;    Trajectory;   

DOI  :  10.1186/s12967-020-02361-5

来源: DOAJ

【 摘 要 】

Abstract Background The association between blood pressure change and kidney damage in patients with abnormal blood glucose remains unclear. The current study aimed to identify systolic blood pressure (SBP) trajectories among the prediabetic population and to determine their association with kidney damage after a long-term follow-up. Methods The incidence, development, and prognosis of diabetic kidney disease (INDEED) study is nested in the Kailuan cohort study with a focus on population with diabetes and prediabetes. We screened out people with prediabetes in 2006 and with more than three SBP records from 2006 to 2014 biennially. We used the latent mixture modeling to fit five groups of trajectories of SBP. In 2016, estimated glomerular filtration rate (eGFR), urinary albumin creatinine ratio (uACR), and urinary α1-microglobulin (α1MG), transferrin and α1-acid glycoprotein were measured, and the association between SBP trajectories and these markers was analyzed by linear regression and logistic regression models. Results Totally, 1451 participants with prediabetes and without kidney damage were identified in 2006. Five heterogeneous SBP trajectories were detected based on the longitudinal data from 2006 to 2014, as low-stable group (n = 323), moderate-stable group (n = 726), moderate-increasing group (n = 176), moderate-decreasing group (n = 181), and high-stable group (n = 45). Linear regression analysis showed that the moderate and high SBP groups had lower eGFR, higher uACR, higher urinary α1MG, higher transferrin, and higher α1-acid glycoprotein than the low-stable group. Multivariable analysis attenuated the association but did not change the statistical significance. Conclusions Prediabetic patients with persistent high-level SBP trajectory or gradually increased SBP trajectory had severer kidney damage during follow-up.

【 授权许可】

Unknown