Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study
BackgroundDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide. Epidemiological evidence of the association between urinary sodium excretion and the presence of DKD in patients with type 2 diabetes mellitus (T2DM) has not yet been well established.MethodsWe perfor...
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.772073/full |
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| author | Yan Huang Wenhui Liu Jianfang Liu Dan Guo Peizhen Zhang Deying Liu Jiayang Lin Linjie Yang Huijie Zhang Huijie Zhang Huijie Zhang Yaoming Xue |
| author_facet | Yan Huang Wenhui Liu Jianfang Liu Dan Guo Peizhen Zhang Deying Liu Jiayang Lin Linjie Yang Huijie Zhang Huijie Zhang Huijie Zhang Yaoming Xue |
| author_sort | Yan Huang |
| collection | DOAJ |
| description | BackgroundDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide. Epidemiological evidence of the association between urinary sodium excretion and the presence of DKD in patients with type 2 diabetes mellitus (T2DM) has not yet been well established.MethodsWe performed a cross-sectional study of 1545 patients with T2DM over aged 20 years old from January 2018 to December 2020. Urinary sodium excretion was measured by 24-hour urine samples in inpatients and morning fasting urine samples in outpatients. The associations between urinary sodium excretion and the risks of DKD were examined using stepwise regression analysis, logistic regression analysis and multivariable-adjusted restricted cubic splines (RCS).ResultsRegression analysis showed that urinary sodium was independently associated with urinary albumin to creatinine ratio (UACR) level (P = 0.006) and the risks of DKD (P = 0.042). In multivariable-adjusted RCS analysis, urinary sodium excretion was significantly associated with UACR in all patients (P = 0.008), and exhibited a J-shaped relationship. Logistic regression analysis showed that increased urinary sodium excretion was significantly associated with increased risks of DKD [OR (95% CI); 1.56 (1.07-2.27); P = 0.020]. However, the relationships between urinary sodium excretion and the risks of DKD and albuminuria showed no significance, after further adjustment for HOMA-IR and ba-PWV (brachial-ankle pulse wave velocity) (Both P > 0.05).ConclusionsHigher urinary sodium excretion level was associated with increased risks of DKD among patients with T2DM, dependent of vascular sclerosis and insulin resistance. |
| first_indexed | 2024-12-17T06:07:13Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-17T06:07:13Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-0d4130703ef747a8948ed4cc3464c0d42022-12-21T22:00:44ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-10-011210.3389/fendo.2021.772073772073Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional StudyYan Huang0Wenhui Liu1Jianfang Liu2Dan Guo3Peizhen Zhang4Deying Liu5Jiayang Lin6Linjie Yang7Huijie Zhang8Huijie Zhang9Huijie Zhang10Yaoming Xue11Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Shock and Microcirculation, Guangzhou, ChinaDepartment of Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, ChinaDepartment of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaBackgroundDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide. Epidemiological evidence of the association between urinary sodium excretion and the presence of DKD in patients with type 2 diabetes mellitus (T2DM) has not yet been well established.MethodsWe performed a cross-sectional study of 1545 patients with T2DM over aged 20 years old from January 2018 to December 2020. Urinary sodium excretion was measured by 24-hour urine samples in inpatients and morning fasting urine samples in outpatients. The associations between urinary sodium excretion and the risks of DKD were examined using stepwise regression analysis, logistic regression analysis and multivariable-adjusted restricted cubic splines (RCS).ResultsRegression analysis showed that urinary sodium was independently associated with urinary albumin to creatinine ratio (UACR) level (P = 0.006) and the risks of DKD (P = 0.042). In multivariable-adjusted RCS analysis, urinary sodium excretion was significantly associated with UACR in all patients (P = 0.008), and exhibited a J-shaped relationship. Logistic regression analysis showed that increased urinary sodium excretion was significantly associated with increased risks of DKD [OR (95% CI); 1.56 (1.07-2.27); P = 0.020]. However, the relationships between urinary sodium excretion and the risks of DKD and albuminuria showed no significance, after further adjustment for HOMA-IR and ba-PWV (brachial-ankle pulse wave velocity) (Both P > 0.05).ConclusionsHigher urinary sodium excretion level was associated with increased risks of DKD among patients with T2DM, dependent of vascular sclerosis and insulin resistance.https://www.frontiersin.org/articles/10.3389/fendo.2021.772073/fulldiabetic kidney diseasetype 2 diabetesurinary sodium excretioninsulin resistancevascular sclerosis |
| spellingShingle | Yan Huang Wenhui Liu Jianfang Liu Dan Guo Peizhen Zhang Deying Liu Jiayang Lin Linjie Yang Huijie Zhang Huijie Zhang Huijie Zhang Yaoming Xue Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study Frontiers in Endocrinology diabetic kidney disease type 2 diabetes urinary sodium excretion insulin resistance vascular sclerosis |
| title | Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study |
| title_full | Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study |
| title_fullStr | Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study |
| title_full_unstemmed | Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study |
| title_short | Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study |
| title_sort | association of urinary sodium excretion and diabetic kidney disease in patients with type 2 diabetes mellitus a cross sectional study |
| topic | diabetic kidney disease type 2 diabetes urinary sodium excretion insulin resistance vascular sclerosis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.772073/full |
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