Relationship between age of onset of type 2 diabetes mellitus and renal prognosis in diabetic nephropathy
10.3760/cma.j.cn431274-20240331-00552
- VernacularTitle:2型糖尿病发病年龄与糖尿病肾病患者肾脏预后的关系
- Author:
Gouqin WANG
1
;
Xue MA
1
;
Yingying WANG
1
Author Information
1. 兰州大学第二医院肾内科，兰州 730030
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus, type 2;
Age of onset;
Diabetic nephropathies;
Prognosis
- From:
Journal of Chinese Physician
2025;27(2):236-240
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between age of onset of type 2 diabetes mellitus and renal prognosis in diabetic nephropathy (DN) patients.Methods:A total of 76 diabetic nephropathy patients diagnosed by kidney biopsy in the Second Hospital of Lanzhou University from January 2017 to January 2019 were included. Type 2 diabetes was divided into early onset group (26 cases, onset age <40 years old) and late onset group (50 cases, onset age ≥40 years old) according to the onset age of type 2 diabetes. Clinical parameters, pathological characteristics of renal tissue and correlation between clinical parameters and renal pathology of the two groups were analyzed when DN was diagnosed. After 5 years of follow-up, Log-rank test and Cox univariate regression analysis were used to determine the renal prognosis of the two groups.Results:Compared with the late onset group, the onset age of diabetes and the time of renal biopsy were earlier in the early onset group, and the duration of diabetes was longer when kidney injury occurred in the early onset group (all P<0.05). Compared with the late group, the glomerular basement membrane (GBM) was thicker in the early group ( P=0.035). GBM thickness was negatively correlated with age at onset of type 2 diabetes ( r=-0.359, P=0.003), positively correlated with duration of diabetes ( r=0.300, P=0.023), but not with age at renal biopsy ( r=-0.205, P=0.144). During follow-up, 3 and 5 patients died in the early-onset and late-onset groups, and 11 and 28 patients progressed to end-stage renal disease (ESRD), respectively. The 5-year cumulative renal survival rate in the two groups was 36.4% and 20.7%, respectively. Log-rank test showed similar renal outcomes in the two groups ( P=0.340). The risk of progression to ESRD was similar between the two groups ( HR=1.045; 95% CI: 0.977 to 1.117, P=0.199), and the estimated annual decline in estimated glomerular filtration rate (eGFR) was similar between the two groups [(26.40±21.25)% vs (33.32±25.53)%, P=0.248]. Conclusions:During 5-year follow-up, the risk of progression to ESRD was similar in the early-onset and late-onset groups. The early-onset group did not show a faster decline in renal function and a worse renal prognosis.
