Impact of salt intake on urinary albumin excretion in patients with type 2 diabetic nephropathy: a retrospective cohort study based on a generalized additive model
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- Kotake Yuka
- Division of Economics, Graduate School of Human and Socio-Environmental Studies, Kanazawa University, Kanazawa, Japan
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- Karashima Shigehiro
- Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
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- Kawakami Masaki
- School of Electrical, Information, and Communication Engineering, College of Science and Engineering, Kanazawa University, Kanazawa, Japan
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- Hara Satoshi
- Medical Education Research Center, Kanazawa University, Medical Education Research Center, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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- Aono Daisuke
- Department of Endocrinology and Metabolism, Kanazawa University Hospital, Kanazawa, Japan
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- Konishi Seigo
- Department of Endocrinology and Metabolism, Kanazawa University Hospital, Kanazawa, Japan
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- Kometani Mitsuhiro
- Department of Endocrinology and Metabolism, Kanazawa University Hospital, Kanazawa, Japan
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- Mori Hiroyuki
- University of Michigan Medical School, Department of Molecular & Integrative Physiology, Ann Arbor, MI, USA
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- Takeda Yoshiyu
- Department of Internal Medicine, Asanogawa General Hospital, Kanazawa, Japan
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- Yoneda Takashi
- Department of Endocrinology and Metabolism, Kanazawa University Hospital, Kanazawa, Japan Institute of Transdisciplinary Sciences, Kanazawa University, Kanazawa, Japan Department of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, Japan
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- Nambo Hidetaka
- School of Electrical, Information, and Communication Engineering, College of Science and Engineering, Kanazawa University, Kanazawa, Japan
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- Furukawa Kenji
- Center of Diabetes and Metabolism, Japan Community Healthcare Organization Kanazawa Hospital, Kanazawa, Japan Health Care Center, Japan Advanced Institute of Science and Technology, Nomi, Japan
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抄録
<p>Diabetic kidney disease is an important and common cause of end-stage renal disease. Measurement of urinary albumin excretion (UAE) requires the diagnosis of the stage of diabetic nephropathy and the prognosis of renal function. We aimed to analyze the impact of lifestyle modification on UAE in patients with stage 2 and 3 type 2 diabetic nephropathy who received comprehensive medical care, using a generalized additive model (GAM), an explanatory machine learning model. In this retrospective observational study, we used changes in HbA1c, systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels; body mass index (BMI); and daily salt intake as factors contributing to changes in UAE. In total, 269 patients with type 2 diabetic nephropathy were enrolled (stage 2, 217 patients; stage 3, 52 patients). The rankings that contributed to changes in UAE over 6 months by permutation importance were the changes in daily salt intake, HbA1c, SBP, DBP, and BMI. GAM, which predicts the change in UAE, showed that with increase in the changes in salt intake, SBP, and HbA1c, the delta UAE tended to increase. Salt intake was the most contributory factor for the changes in UAE, and daily salt intake was the best lifestyle factor to explain the changes in UAE. Strict control of salt intake may have beneficial effects on improving UAE in patients with stage 2 and 3 diabetic nephropathy.</p>
収録刊行物
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- Endocrine Journal
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Endocrine Journal 69 (5), 577-583, 2022
一般社団法人 日本内分泌学会
