Loss of Inverse Association between Framingham Risk Score and Estimated Glomerular Filtration Rate in Moderate to Severe Diabetic Kidney Disease

Pegah Khaloo, Hamid Alemi, Mohammad Ali Mansournia, Soghra Rabizadeh, Salome Sadat Salehi, Michael Blaha, Mohammad Hassan Mirbolouk, Hossein Mirmiranpour, Alireza Esteghamati, Manouchehr Nakhjavani

Research output: Contribution to journalArticle

Abstract

BACKGROUND: We investigated the association of estimated glomerular filtration rate (eGFR) with Framingham risk score (FRS), and actual cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM). We also assessed improvement in FRS for prediction of CVD after inclusion of eGFR and albuminuria. METHODS: A total of 571 patients with T2DM and mean age 55 were divided into 2 groups based on the presence of CVD. Participants without CVD were then divided into three groups according to FRS. CVD is defined as an episode of CCU admission, Myocardial infarction, history of coronary artery bypass graft surgery or percutaneous intervention. FRS is calculated using the Wilson 1998 Circulation equation, which includes age, sex, high blood pressure, smoking, high-density lipoprotein (HDL), total cholesterol and diabetes as components to assess CVD risk in 10 years. RESULTS: An inverse adjusted association between eGFR and prevalent CVD was confirmed by multiple logistic regression analysis (OR = 0.84, 95% CI: 0.74, 0.94, P = 0.03). We observed every 10 mL/min/1.73 m2 decrease in eGFR is related to 3% increase in FRS in patients without chronic kidney disease (CKD) (coefficient = -0.03, P < 0.001). The association between FRS and GFR and also CVD and eGFR were not significant in patients with CKD (P = 0.12; P = 0.17, respectively). Predictive values for FRS components with and without considering eGFR and albuminuria were calculated (0.74 and 0.75, respectively). CONCLUSION: Inclusion of eGFR and albuminuria in the FRS formula did not improve the predictive value of the model. We showed an inverse association between eGFR and FRS in early stages of diabetic kidney disease, which was lost in patients with CKD.

Original languageEnglish (US)
Pages (from-to)91-98
Number of pages8
JournalArchives of Iranian medicine
Volume22
Issue number2
StatePublished - Feb 1 2019

Fingerprint

Diabetic Nephropathies
Glomerular Filtration Rate
Cardiovascular Diseases
Albuminuria
Chronic Renal Insufficiency
Coronary Artery Bypass
Type 2 Diabetes Mellitus
HDL Cholesterol
Logistic Models
Smoking
Myocardial Infarction
Regression Analysis
Hypertension
Transplants

Keywords

  • Cardiovascular disease
  • Diabetic nephropathy
  • eGFR
  • Framingham risk score
  • Type 2 diabetes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Loss of Inverse Association between Framingham Risk Score and Estimated Glomerular Filtration Rate in Moderate to Severe Diabetic Kidney Disease. / Khaloo, Pegah; Alemi, Hamid; Mansournia, Mohammad Ali; Rabizadeh, Soghra; Salehi, Salome Sadat; Blaha, Michael; Mirbolouk, Mohammad Hassan; Mirmiranpour, Hossein; Esteghamati, Alireza; Nakhjavani, Manouchehr.

In: Archives of Iranian medicine, Vol. 22, No. 2, 01.02.2019, p. 91-98.

Research output: Contribution to journalArticle

Khaloo, P, Alemi, H, Mansournia, MA, Rabizadeh, S, Salehi, SS, Blaha, M, Mirbolouk, MH, Mirmiranpour, H, Esteghamati, A & Nakhjavani, M 2019, 'Loss of Inverse Association between Framingham Risk Score and Estimated Glomerular Filtration Rate in Moderate to Severe Diabetic Kidney Disease', Archives of Iranian medicine, vol. 22, no. 2, pp. 91-98.
Khaloo, Pegah ; Alemi, Hamid ; Mansournia, Mohammad Ali ; Rabizadeh, Soghra ; Salehi, Salome Sadat ; Blaha, Michael ; Mirbolouk, Mohammad Hassan ; Mirmiranpour, Hossein ; Esteghamati, Alireza ; Nakhjavani, Manouchehr. / Loss of Inverse Association between Framingham Risk Score and Estimated Glomerular Filtration Rate in Moderate to Severe Diabetic Kidney Disease. In: Archives of Iranian medicine. 2019 ; Vol. 22, No. 2. pp. 91-98.
@article{ac05dd8377f3460993d45406125cb1a3,
title = "Loss of Inverse Association between Framingham Risk Score and Estimated Glomerular Filtration Rate in Moderate to Severe Diabetic Kidney Disease",
abstract = "BACKGROUND: We investigated the association of estimated glomerular filtration rate (eGFR) with Framingham risk score (FRS), and actual cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM). We also assessed improvement in FRS for prediction of CVD after inclusion of eGFR and albuminuria. METHODS: A total of 571 patients with T2DM and mean age 55 were divided into 2 groups based on the presence of CVD. Participants without CVD were then divided into three groups according to FRS. CVD is defined as an episode of CCU admission, Myocardial infarction, history of coronary artery bypass graft surgery or percutaneous intervention. FRS is calculated using the Wilson 1998 Circulation equation, which includes age, sex, high blood pressure, smoking, high-density lipoprotein (HDL), total cholesterol and diabetes as components to assess CVD risk in 10 years. RESULTS: An inverse adjusted association between eGFR and prevalent CVD was confirmed by multiple logistic regression analysis (OR = 0.84, 95{\%} CI: 0.74, 0.94, P = 0.03). We observed every 10 mL/min/1.73 m2 decrease in eGFR is related to 3{\%} increase in FRS in patients without chronic kidney disease (CKD) (coefficient = -0.03, P < 0.001). The association between FRS and GFR and also CVD and eGFR were not significant in patients with CKD (P = 0.12; P = 0.17, respectively). Predictive values for FRS components with and without considering eGFR and albuminuria were calculated (0.74 and 0.75, respectively). CONCLUSION: Inclusion of eGFR and albuminuria in the FRS formula did not improve the predictive value of the model. We showed an inverse association between eGFR and FRS in early stages of diabetic kidney disease, which was lost in patients with CKD.",
keywords = "Cardiovascular disease, Diabetic nephropathy, eGFR, Framingham risk score, Type 2 diabetes",
author = "Pegah Khaloo and Hamid Alemi and Mansournia, {Mohammad Ali} and Soghra Rabizadeh and Salehi, {Salome Sadat} and Michael Blaha and Mirbolouk, {Mohammad Hassan} and Hossein Mirmiranpour and Alireza Esteghamati and Manouchehr Nakhjavani",
year = "2019",
month = "2",
day = "1",
language = "English (US)",
volume = "22",
pages = "91--98",
journal = "Archives of Iranian Medicine",
issn = "1029-2977",
publisher = "Academy of Medical Sciences of I.R. Iran",
number = "2",

}

TY - JOUR

T1 - Loss of Inverse Association between Framingham Risk Score and Estimated Glomerular Filtration Rate in Moderate to Severe Diabetic Kidney Disease

AU - Khaloo, Pegah

AU - Alemi, Hamid

AU - Mansournia, Mohammad Ali

AU - Rabizadeh, Soghra

AU - Salehi, Salome Sadat

AU - Blaha, Michael

AU - Mirbolouk, Mohammad Hassan

AU - Mirmiranpour, Hossein

AU - Esteghamati, Alireza

AU - Nakhjavani, Manouchehr

PY - 2019/2/1

Y1 - 2019/2/1

N2 - BACKGROUND: We investigated the association of estimated glomerular filtration rate (eGFR) with Framingham risk score (FRS), and actual cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM). We also assessed improvement in FRS for prediction of CVD after inclusion of eGFR and albuminuria. METHODS: A total of 571 patients with T2DM and mean age 55 were divided into 2 groups based on the presence of CVD. Participants without CVD were then divided into three groups according to FRS. CVD is defined as an episode of CCU admission, Myocardial infarction, history of coronary artery bypass graft surgery or percutaneous intervention. FRS is calculated using the Wilson 1998 Circulation equation, which includes age, sex, high blood pressure, smoking, high-density lipoprotein (HDL), total cholesterol and diabetes as components to assess CVD risk in 10 years. RESULTS: An inverse adjusted association between eGFR and prevalent CVD was confirmed by multiple logistic regression analysis (OR = 0.84, 95% CI: 0.74, 0.94, P = 0.03). We observed every 10 mL/min/1.73 m2 decrease in eGFR is related to 3% increase in FRS in patients without chronic kidney disease (CKD) (coefficient = -0.03, P < 0.001). The association between FRS and GFR and also CVD and eGFR were not significant in patients with CKD (P = 0.12; P = 0.17, respectively). Predictive values for FRS components with and without considering eGFR and albuminuria were calculated (0.74 and 0.75, respectively). CONCLUSION: Inclusion of eGFR and albuminuria in the FRS formula did not improve the predictive value of the model. We showed an inverse association between eGFR and FRS in early stages of diabetic kidney disease, which was lost in patients with CKD.

AB - BACKGROUND: We investigated the association of estimated glomerular filtration rate (eGFR) with Framingham risk score (FRS), and actual cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM). We also assessed improvement in FRS for prediction of CVD after inclusion of eGFR and albuminuria. METHODS: A total of 571 patients with T2DM and mean age 55 were divided into 2 groups based on the presence of CVD. Participants without CVD were then divided into three groups according to FRS. CVD is defined as an episode of CCU admission, Myocardial infarction, history of coronary artery bypass graft surgery or percutaneous intervention. FRS is calculated using the Wilson 1998 Circulation equation, which includes age, sex, high blood pressure, smoking, high-density lipoprotein (HDL), total cholesterol and diabetes as components to assess CVD risk in 10 years. RESULTS: An inverse adjusted association between eGFR and prevalent CVD was confirmed by multiple logistic regression analysis (OR = 0.84, 95% CI: 0.74, 0.94, P = 0.03). We observed every 10 mL/min/1.73 m2 decrease in eGFR is related to 3% increase in FRS in patients without chronic kidney disease (CKD) (coefficient = -0.03, P < 0.001). The association between FRS and GFR and also CVD and eGFR were not significant in patients with CKD (P = 0.12; P = 0.17, respectively). Predictive values for FRS components with and without considering eGFR and albuminuria were calculated (0.74 and 0.75, respectively). CONCLUSION: Inclusion of eGFR and albuminuria in the FRS formula did not improve the predictive value of the model. We showed an inverse association between eGFR and FRS in early stages of diabetic kidney disease, which was lost in patients with CKD.

KW - Cardiovascular disease

KW - Diabetic nephropathy

KW - eGFR

KW - Framingham risk score

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85064841833&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064841833&partnerID=8YFLogxK

M3 - Article

C2 - 30980645

AN - SCOPUS:85064841833

VL - 22

SP - 91

EP - 98

JO - Archives of Iranian Medicine

JF - Archives of Iranian Medicine

SN - 1029-2977

IS - 2

ER -