The relationship between chronic kidney disease and cardiovascular pathology in patients with type 2 diabetes of different ages
Article Sidebar
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Main Article Content
https://orcid.org/0000-0003-1953-1066
Abstract
The aim – to analyze the relationship between chronic kidney disease (CKD) and cardiovascular pathology in patients with type 2 diabetes (T2D) of different ages.
Materials and methods. A total of 233 patients with T2D aged 30-80 years were examined. Anthropometric indicators, blood pressure, glucose levels, glycated hemoglobin, C-peptide, total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterol, creatinine, glomerular filtration rate, AST, and ALT were measured in all patients. Groups of patients were compared based on the presence of CKD and age using Student’s t-test and Pearson’s chi-squared test.
Results and discussion. In patients with T2D and CKD, the incidence of coronary heart disease (CHD) (OR 1.8; 95 % CI 1.02–3.23; p=0.044), myocardial infarction (OR 2.0; 95 % CI 1.01–3.95; p=0.046), and strokes (OR 2.66; 95 % CI 1.07–6.63; p=0.036) is significantly higher compared to patients with T2D without kidney pathology. When comparing the clinical indicators of patients with T2D combined with CKD and those without it, no significant differences were found in anthropometric measurements, blood pressure, blood glucose levels, glycated hemoglobin, or C-peptide levels. The levels of total cholesterol, hemoglobin, and red blood cell count in the blood were significantly lower (р<0.05), while the levels of creatinine and glomerular filtration rate were significantly higher (р<0.001) in patients with kidney pathology.
Conclusion. In patients with T2D, a relationship between CKD and cardiovascular pathology has been established. It can be assumed that the development of kidney pathology in patients with T2D is a significant risk factor for cardiovascular diseases.
Article Details
Keywords:
References
Ali MK, Pearson-Stuttard J, Selvin E, Gregg EW. Interpreting global trends in type 2 diabetes complications and mortality. Diabetologia. 2022;65(1):3-13. https://doi.org/10.1007/s00125-021-05585-2.
Beverly JK, Budoff MJ. Atherosclerosis: pathophysiology of insulin resistance, hyperglycemia, hyperlipidemia, and inflammation. J Diabetes. 2020;12(2):102-4. https://doi.org/10.1111/1753-0407.12970.
Seo D, Kim M, Suh YJ, Cho Y, Ahn SH, Hong S, Kim SH. Association between age at diagnosis of type 2 diabetes and cardiovascular morbidity and mortality risks: A nationwide population-based study. Diabetes Research and Clinical Practice. 2024;208,111098. https://doi.org/10.1016/j.diabres.2024.111098.
de Jong M, Woodward M, Peters SAE. Duration of diabetes and the risk of major cardiovascular events in women and men: a prospective cohort study of UK biobank participants. Diabetes Res Clin Pract. 2022;188:109899. https://doi.org/10.1016/j.diabres.2022.109899.
Iglesias P, Heras M, Diez JJ. Diabetes mellitus and kidney disease in the elderly. Nefrologia (English Edition). 2014;34(3):285-92. https://doi.org/10.3265/Nefrologia.pre2014.Feb.12319.
Han T, Lean M. Metabolic syndrome. Medicine. 2015;43(2):80-7.
Huang JX, Liao YF, Li YM. Clinical features and microvascular complications risk factors of early-onset type 2 diabetes mellitus. Curr Med Sci. 2019;39(5):754-8. https://doi.org/10.1007/s11596-019-2102-7.
Huang L, Wu P, Zhang Y, Lin Y, Shen X, Zhao F, Yan S. Relationship between onset age of type 2 diabetes mellitus and vascular complications based on propensity score matching analysis. J Diabetes Investig. 2022;13(6):1062-72. https://doi.org/10.1111/jdi.13763.
Jin JL, Zhang HW, Cao YX, Liu HH, Hua Q, Li YF. Association of small dense low-density lipoprotein with cardiovascular outcome in patients with coronary artery disease and diabetes: a prospective, observational cohort study. Cardiovasc Diabetol. 2020;19(1):45. https://doi.org/10.1186/s12933-020-01015-6.
Kim SM, Lee G, Choi S, Kim K, Jeong SM, Son JS. Association of early-onset diabetes, prediabetes and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia. 2020;63(11):2305-14. https://doi.org/10.1007/s00125-020-05252-y.
Knapp M, Tu X, Wu R. Vascular endothelial dysfunction, a major mediator in diabetic cardiomyopathy. Acta Pharmacol Sin. 2019;40(1):1-8. https://doi.org/10.1038/s41401-018-0042-6.
Mancia G. The association of hypertension and diabetes: prevalence, cardiovascular risk and protection by blood pressure reduction. Acta Diabetol. 2005;42:17-25.
Nanayakkara N, Curtis AJ, Heritier S, Gadowski AM, Pavkov ME, Kenealy T. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia. 2021;64(2):275-87. https://doi.org/10.1007/s00125-020-05319-w.
Østergaard L, Mogensen UM, Bundgaard JS, Dahl A, Wang A, Torp-Pedersen C. Duration and complications of diabetes mellitus and the associated risk of infective endocarditis. Int J Cardiol. 2019;278:280-4. https://doi.org/10.1016/j.ijcard.2018.09.106.
Polemiti E, Baudry J, Kuxhaus O, Jäger S, Bergmann MM, Weikert C. BMI and BMI change following incident type 2 diabetes and risk of microvascular and macrovascular complications: the EPIC-potsdam study. Diabetologia. 2021;64(4):814-25. https://doi.org/10.1007/s00125-020-05362-7
Sattar N, Rawshani A, Franzén S, Rawshani A, Svensson A, Rosengren A, McGuire D, Eliasson B, Gudbjörnsdottir S. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation. 2019;139(19):2228-37. https://doi.org/10.1161/CIRCULATIONAHA.118.037885.
Sloten TT, Sedaghat S, Carnethon MR, Launer LJ, Stehouwer CDA. Cerebral microvascular complications of type 2 diabetes: stroke, cognitive dysfunction, and depression. Lancet Diabetes Endocrinol. 2020;8(4):325-36. https://doi.org/10.1016/S2213-8587(19)30405-X.
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109-19. https://doi.org/10.1016/j.diabres.2021.109119.
Thomas MC, Brownlee M, Susztak K, Sharma K, Jandeleit-Dahm KA, Zoungas S, Rossing P, Groop PH, Cooper ME. Diabetic kidney disease. Nat Rev Dis Primers. 2015;1:150-18. https://doi.org/10.1038/nrdp.2015.18.
Yao X, Zhang J, Zhang X, Jiang T, Zhang Y, Dai F, Hu H, Zhang Q Age at diagnosis, diabetes duration and the risk of cardiovascular disease in patients with diabetes mellitus: a cross-sectional study. Front Endocrinol. 2023;14:113-95. https://doi.org/10.3389/fendo.2023.1131395.
Yokoi T, Fukuo K, Yasuda O, Hotta M, Miyazaki J, Takemura Y, Ogihara T. Apoptosis signal-regulating kinase 1 mediates cellular senescence induced by high glucose in endothelial cells. Diabetes. 2006;55:1660–5. https://doi.org/10.2337/db05-1607.
Yousri NA, Suhre K, Yassin E, Al-Shakaki A, Robay A, Elshafei M. Metabolic and metabo-clinical signatures of type 2 diabetes, obesity, retinopathy, and dyslipidemia. Diabetes. 2022;71(2):184-205. https://doi.org/10.2337/db21-0490.