Hyperglycaemia, dyslipidemia up risk of diabetic kidney disease

A recent study has identified six common metabolic profiles among patients with type 2 diabetes (T2D). In addition, severe hyperglycaemia and moderate dyslipidemia are associated with an increased risk of diabetic kidney disease (DKD).

Six clusters were classified as metabolic profiles in the derivation cohort. Compared with cluster 1, cluster 3 (severe hyperglycaemia) were found to have higher risk of DKD (hazard ratio [HR], 1.72, 95 percent confidence interval [CI], 1.39‒2.12), macroalbuminuria (HR, 2.74, 95 percent CI, 1.84‒4.08), end-stage renal disease (ESRD; HR, 4.31, 95 percent CI, 1.16‒15.99), and estimated glomerular filtration rate (eGFR) decline (p<0.001).

Likewise, cluster 4 (moderate dyslipidemia) showed elevated risks of DKD (HR, 1.97, 95 percent CI, 1.53‒2.54) and macroalbuminuria (HR, 2.62, 95 percent CI, 1.61‒4.25).

In the validation cohort, clusters 3 (adjusted odds ratio [aOR], 1.24, 95 percent CI, 1.07‒1.44) and 4 (aOR, 1.39, 95 percent CI, 1.03‒1.87) remained to exhibit substantially higher risks of DKD.

This study included a total of 3,556 patients with T2D (derivation cohort) and 931 with T2D from a community survey (external validation cohort). DKD onset served as the primary outcome, while secondary ones included eGFR decline, macroalbuminuria, and ESRD.

In the derivation cohort, the investigators identified clusters using the five components of metabolic syndrome and assessed their associations with the outcomes. To confirm findings, they assigned the participants in the validation cohort to clusters. Multivariate ORs of the primary outcomes were assessed in both cohorts, with adjustments for covariates at baseline.