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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3780

Title: Renal arteriolar hyalinosis, not intimal thickening in large arteries, is associated with cardiovascular events in people with biopsy‐proven diabetic nephropathy.
Other Titles: 腎細動脈のヒアリノーシスは、大動脈の内膜肥厚とは異なり、腎生検で証明された糖尿病性腎症患者の心血管イベントに関連する。
Authors: Morimoto, Katsuhiko
Matsui, Masaru
Samejima, Ken-ichi
Kanki, Tomoko
Nishimoto, Masatoshi
Tanabe, Kaori
Murashima, Miho
Eriguchi, Masahiro
Akai, Yasuhiro
Iwano, Masayuki
Shiiki, Hideo
Yamada, Hiroharu
Kanauchi, Masao
Dohi, Kazuhiro
Tsuruya, Kazuhiko
Saito, Yoshihiko
Issue Date: Dec-2020
Publisher: Wiley
Citation: Diabetic medicine Vol.37 No.12 p.2143-2152 (2020 Dec)
Abstract: Aims: Diabetic nephropathy, a pathologically diagnosed microvascular complication of diabetes, is a strong risk factor for cardiovascular events, which mainly involve arteries larger than those affected in diabetic nephropathy. However, the association between diabetic nephropathy pathological findings and cardiovascular events has not been well studied. We aimed to investigate whether the pathological findings in diabetic nephropathy are closely associated with cardiovascular event development. Methods: This retrospective cohort study analysed 377 people with type 2 diabetes and biopsy‐proven diabetic nephropathy, with a median follow‐up of 5.9 years (interquartile range 2.0 to 13.5). We investigated how cardiovascular events were impacted by two vascular diabetic nephropathy lesions, namely arteriolar hyalinosis and arterial intimal thickening, and by glomerular and interstitial lesions. Results: Of the 377 people with diabetic nephropathy, 331 (88%) and 295 (78%) had arteriolar hyalinosis and arterial intimal thickening, respectively. During the entire follow‐up period, those with arteriolar hyalinosis had higher cardiovascular event rates in the crude Kaplan–Meier analysis than those without these lesions (P = 0.005, log‐rank test). When fully adjusted for clinically relevant confounders, arteriolar hyalinosis independently predicted cardiovascular events [hazard ratio (HR) 1.99; 95% confidence interval (CI) 1.12, 3.86], but we did not find any relationship between arterial intimal thickening and cardiovascular events (HR 0.89; 95% CI 0.60, 1.37). Additionally, neither glomerular nor interstitial lesions were independently associated with cardiovascular events in the fully adjusted model. Conclusions: Arteriolar hyalinosis, but not intimal thickening of large arteries, was strongly associated with cardiovascular events in people with diabetic nephropathy.
Description: 博士(医学)・乙第1464号・令和2年9月30日
© 2020 Diabetes UK
This is the peer reviewed version of the following article: [https://onlinelibrary.wiley.com/doi/10.1111/dme.14301], which has been published in final form at [https://doi.org/10.1111/dme.14301]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
発行元が定める登録猶予期間終了の後、本文を登録予定(2021.12)
URI: http://hdl.handle.net/10564/3780
ISSN: 07423071
Academic Degrees and number: 24601B1464
Degree-granting date: 2020-09-30
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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