关键词: 心血管疾病, 尿微量白蛋白与尿肌酐比值, 估算肾小球滤过率, 2型糖尿病

Abstract: Objective To investigate whether the renal function assessed by estimated glomerular filtration rate(eGFR)and urinealbumin-to-creatinine rate(uACR)is consistent and explore the effect of the combination of the two on new-onset Cardia-cerebrovascular disease(CVD)in population with type 2 diabetes mellitus(T2DM). Methods We included 8 791 participants with T2DM but no CVD who were assessed with uACR and eGFR between 2014 and 2016. The participants were divided into four groups based on their baseline uACR and eGFR: normal(uACR<3 mg/mmol and eGFR≥90 mL·min^-1·1.73 m^<sup>-2), simple eGFR decreaed(uACR<3 mg/mmol and eGFR<90 mL·min^-1·1.73 m^<sup>-2), simple uACR increased(uACR≥3 mg/mmol and eGFR≥90 mL·min^-1·1.73 m^<sup>-2), uACR increased and eGFR decreaed(uACR≥3 mg/mmol and eGFR<90 mL·min^-1·1.73 m^<sup>-2). The relationship between uACR and eGFR and new-onset CVD was studied using Cox proportional hazard models. Results There were 79.05% males in all participants with an average age of 60.97 years old. Their median uACR was 1.68(0.81, 4.60)mg/mmol and mean of eGFR was(92.14±16.52)mL·min^-1·1.73 m^<sup>-2),increased uACR and decreased eGFR were inconsistent in 43.59%. 694 new-onset CVD cases(7.89%)were recorded after a median follow-up of 3.83 years. The incidence of CVD in all four groups was 12.96/1 000 preson-years,19.04/1 000 preson-years, 25.65/1 000 preson-years and 46.87/1 000 preson-years, respectively. When compared with normal, multivariable-adjustted hazard ratios of CVD were 1.06(95%CI 0.73~1.55), 1.99(95%CI 1.41~2.80)and 3.00(95%CI 2.12~4.25)in simple eGFR decreaed group, simple uACR increased group, uACR increased and eGFR decreaed group, respectively. Conclusion Inconsistencies in renal function assessed by decreased eGFR and increased uACR are common, there is a joint effect of the two methods on the prediction of new CVD.

Key words: cardiovascular disease, urine albumin-to-creatinine ratio, estimated glomerular filtration rate, type 2 diabetes