文献类型：期刊文献

英文题名：Exploring the Incidence and Risk Factors of Diabetic Nephropathy in Type 1 Diabetes: Insights from a Retrospective Cohort Study in Northwest China

作者：Du, Zouxi[1,2];Liu, Xiaoning[3];Zhang, Leyuan[4];Zhao, Hui[5,6];Tian, Limin[1,7]

第一作者：Du, Zouxi

通信作者：Tian, LM[1]

机构：[1]Lanzhou Univ, Sch Clin Med 1, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Prov Hosp, Dept Endocrinol, Lanzhou, Gansu, Peoples R China;[3]Lanzhou Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Lanzhou, Gansu, Peoples R China;[4]Gansu Univ Tradit Chinese Med, Clin Coll 1, Lanzhou, Gansu, Peoples R China;[5]Gansu Univ Tradit Chinese Med, Coll Integrated Tradit Chinese & Western Med, Lanzhou, Gansu, Peoples R China;[6]Gansu Prov Hosp, Dept Nephrol, Lanzhou, Gansu, Peoples R China;[7]Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Endocrinol, Chengdu, Sichuan, Peoples R China

第一机构：Lanzhou Univ, Sch Clin Med 1, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Sch Clin Med 1, Lanzhou 730000, Gansu, Peoples R China.

年份：2025

卷号：18

起止页码：2267

外文期刊名：DIABETES METABOLIC SYNDROME AND OBESITY

收录：;Scopus(收录号：2-s2.0-105010971751);WOS:【SCI-EXPANDED(收录号:WOS:001527973000001)】；

基金：This study was supported by the Major Science and Technology Projects in Gansu Province (No. 22ZD6FA033) and Hospital Project of Gansu Provincial Hospital (No. 22GSSYD-52 & No. 22GSSYB-12) .

语种：英文

外文关键词：cumulative incidence; risk factors; type 1 diabetes; type 1 diabetes nephropathy

摘要：Purpose: The study aimed to investigate the incidence of diabetic nephropathy (DN) and their relationship with certain risk factors in patients with type 1 diabetes (T1D) across hospitals in Gansu Province, China. Methods: There were 434 T1D patients recruited from Gansu Province, China, in the present retrospective cohort study between January 2016 and December 2024. Patients were divided into two groups: (i) patients with T1D but without DN and (ii) type 1 diabetic nephropathy (T1DN). Eligibility for T1DN patients included a T1D diagnosis coupled with urine albumin to creatinine ratio >= 30 mg/g. Lifetable method helped determine the cumulative T1DN incidence, and Cox regression helped analyze the associated risk factors. The correlation between predictors (eg, age, serum creatinine (Scr)), and T1DN was assessed with restricted cubic spline curves depending on Cox proportional hazards regression models. Results: The five-year cumulative incidence of T1DN was 29.89%. T1DN risk factors included diabetic ketosis/ketoacidosis (hazard ratio (HR): 1.623, 95% confidence interval (CI): 1.099-2.454, P =0.015) and high Scr levels (HR: 1.003, 95% CI: 1.001-1.006, P =0.010). However, age (HR: 0.534, 95% CI: 0.306-0.710, P < 0.001) and high-density lipoprotein cholesterol (HDL-C) (HR: 0.528, 95% CI: 0.261-0.851, P =0.013) showed a negative association. Significant relationships were not observed with other variables studied, including hypertension, fasting plasma glucose, and postprandial glucose. The dose-response relationship suggested that age, HDL-C, and Scr levels were non-linearly associated with five-year cumulative DN incidences in patients with T1D. Conclusion: Younger age and lower HDL-C levels were identified as risk factors for DN in patients with T1D. Additionally, diabetic ketosis/ketoacidosis and elevated Scr levels were associated with increased DN risk. Early diagnosis and treatment of dyslipidemia are warranted in patients with T1D. Furthermore, close monitoring of patients with diabetic ketosis/ketoacidosis or high Scr levels is crucial for DN management in these patients.