Effects of gender, Helicobacter pylori and hepatitis B virus serology status on cardiovascular and renal complications in Chinese type 2 diabetic patients with overt nephropathy

Authors: Lo, M. K. W.¹; Lee, K.-F.²; Chan, N. N.³; Leung, W. Y. S.³; Ko, G. T. C.⁴; Chan, W.-B.³; So, W.-Y.³; Ng, M. C. Y.³; Ho, C.-S.⁵; Tam, J. S. L.⁶; Lam, C. W. K.⁵; Tong, P. C. Y.³; Chan, J. C. N.³

Source: Diabetes, Obesity and Metabolism, Volume 6, Number 3, May 2004 , pp. 223-230(8)

Publisher: Blackwell Publishing

Key:

- Free Content

- New Content

- Subscribed Content

- Free Trial Content

Abstract:

Background:

The aim of this study was to investigate whether chronic infections with Helicobacter pylori and hepatitis B virus (HBV) might affect clinical outcomes in Chinese type 2 diabetic patients with advanced nephropathy. Methods:

A prospective study of 97 type 2 diabetic patients with clinical proteinuria and renal insufficiency (median serum creatinine 200 µmol/l). Results:

During a median follow-up period of 2 years, 34 developed end-stage renal disease (ESRD), 28 had cardiovascular endpoints and 11 patients had died (seven men and four women), and 52.7% developed a combined endpoint. Female patients had longer disease duration, higher blood pressure, lower body weight but higher serum creatinine and spot urine albumin : creatinine ratio as well as lower haemoglobin than male patients. On logistic regression analysis, female gender (hazard ratio: 5.91, p = 0.02), negative H. pylori serology (8.39, p = 0.004), baseline serum creatinine (1.04, p = 0.001) and haemoglobin (1.86, p = 0.01) were independent predictors for ESRD. Systolic blood pressure (1.04, p = 0.003), prior treatment with angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists (3.41, p = 0.04) and positive hepatitis B surface antigen (4.88, p = 0.025) were independent predictors for cardiovascular endpoints. Female gender (7.89, p = 0.002) and baseline serum creatinine (1.05, p < 0.001) were independent predictors for combined death and cardio-renal endpoints. Conclusions:

In Chinese type 2 diabetic patients with clinical proteinuria renal insufficiency, there were high rates of death and cardio-renal outcomes. Female gender, low haemoglobin and negative H. pylori serology were important predictors for ESRD, whereas chronic HBV infection was associated with increased cardiovascular risks.

Keywords: diabetic nephropathy; end-stage renal disease; Helicobacter pylori; hepatitis B

Document Type: Research article

DOI: 10.1111/j.1462-8902.2004.00338.x

Affiliations: 1: Medical Unit, Pamela Youde Eastern Hospital, Hong Kong 2: Medical Unit, Tung Wah Hospital, Hong Kong 3: Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 4: Medical Unit, Alice Ho Nethersole Hospital, Hong Kong 5: Department of Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 6: Department of Medical Microbiology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$50.39 plus tax Refund Policy

Key:

- Free Content

- New Content

- Subscribed Content

- Free Trial Content

Share this item with others: These icons link to social bookmarking sites where readers can share and discover new web pages.