Search for predictive markers of diabetic kidney disease

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K16539
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: National Cardiovascular Center Research Institute
• Principal Investigator: Koezuka Ryo 国立研究開発法人国立循環器病研究センター, 病院, 医師 (90791864)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 糖尿病性腎臓病 / 心障害マーカー / 心エコー指標

Outline of Final Research Achievements

The aim of this study was to identify risk factors associated with the development and progression of diabetic kidney disease(DKD) in patients with type 2 diabetes and to explore predictive markers of DKD. We have previously reported the correlation between low ABI and eGFR, and between mildly elevated plasma BNP and worsening renal function. Other centers have reported that NT-ProBNP correlates with renal impairment and cardiovascular events. In the present study, our study revealed that high plasma BNP levels were associated with renal events (Cre1.5times increase), and that echocardiographic left atrial diameter enlargement (LAD>37) was associated with an increased risk of renal events. A study using the same database was also able to show that the presence of retinopathy and nephropathy was associated with a higher risk of developing HFpEF.

Free Research Field

内科学一般関連

Academic Significance and Societal Importance of the Research Achievements

今回の後ろ向き観察研究にて、血漿BNP高値や心エコーでLAD高値がDKDの発症・進展に関係することが明らかとなった。
今後、現在行っている前向き観察研究によりこれらの関係性をより明確とし、血糖変動やHDL引き抜き能、尿エクソソームとeGFR変化率との相関を明らかとするため研究を進めている。
COVID-19の流行により新規コホートの症例登録は現在目標登録数の92％と遅れているが、血糖変動、HDL引き抜き能、尿エクソソームとeGFR変化率、尿糸球体障害マーカー、尿細管障害マーカーとの関係性を調査した臨床研究はまだ少なく、学術的・社会的意義を有すると考える。