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Chronic Kidney Disease as a Risk Factor for Coronary Artery Disease in Chinese with Type 2 Diabetes

Hsieh M.-C.a, e, f · Hsiao J.-Y.a · Tien K.-J.b, e · Chang S.-J.c · Hsu S.-C.a · Liang H.-T.a · Chen H.-C.d · Lin S.-R.e, f · Tu S.-T.g
aDivision of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung; bDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan; cDepartment of Public Health, Faculty of Medicine, College of Medicine, Kaohsiung; dDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung; eGraduate institute of Medicine, Kaohsiung Medical University, Kaohsiung; fGraduate Institute of Medical Genetics, Kaohsiung Medical University, Kaohsiung, and gDivision of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan Am J Nephrol 2008;28:317–323 (DOI:10.1159/000111388)

Abstract

Background: Chronic kidney disease (CKD) is associated with cardiovascular disease (CVD) in the general population. We investigated the effects of renal function on coronary artery disease (CAD) in Chinese with type 2 diabetes who have a high risk of developing diabetic nephropathy but who may have a low risk of developing CAD. Methods: We recruited a total of 2,434 Chinese with type 2 diabetes (1,078 men and 1,356 women) and diagnosed CAD by history or with an abnormal electrocardiogram (coronary probable or possible by Minnesota codes). Renal function was evaluated by serum creatinine (SCr) levels, estimated glomerular filtration rate (eGFR) (calculated by the abbreviated Modification of Diet in Renal Disease Study Croup formula) and urinary albumin/creatinine ratio (ACR). Results: We found that patients with CAD were older, had higher SCr levels and body mass index (BMI), and had lower serum high-density lipoprotein cholesterol (HDL-c) levels. After adjusting for age, BMI, blood pressure, glycosylated hemoglobin, cholesterol, LDL-c, HDL-c, and triglycerides, we found that SCr levels >1.5 mg/dl, eGFR <60 ml/min, and urinary ACR >30 mg/g were independent risk factors for CAD in diabetic men, and that SCr levels >1.4 mg/dl and eGFR <60 ml/min were independently associated with CAD in women. Conclusion: Our findings indicate that Chinese with type 2 diabetes and CKD are likely to have had CAD previously and CKD is ‘CVD risk state’ in diabetic Chinese.

 

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