The relationship between haemoglobin level and type 1 diabetic nephropathy in Han patients in Anhui, China

Abstract

Background/aim: Recent studies have shown that low haemoglobin (Hb) levels promote the progression of chronic kidney disease. This study assessed the relationship between Hb level and type 1 diabetic nephropathy (DN) in Han patients in Anhui, China.

Methods: There was a total of 236 patients diagnosed with type 1 diabetes mellitus (T1DM) seen between January 2014 and December 2016 in our centre. Haemoglobin levels in patients with DN were compared with those without DN. The relationship between Hb level and the urinary albumin-creatinine ratio (ACR) was examined by Spearman's correlational analysis and multiple stepwise regression analysis. The binary logistic multivariate regression analysis was performed to analyse the correlated factors for type 1 DN, calculate the odds ratio (OR) and 95% confidence interval (CI). The predicting value of Hb level for DN was evaluated by area under receiver operation characteristic curve (AUROC) for discrimination and Hosmer-Lemeshow goodness-of-fit test for calibration.

Results: The average Hb levels in the DN group (116.1 ± 20.8 g/L) were significantly lower than the non-DN group (131.9 ± 14.4 g/L), P < 0.001. Hb levels were independently correlated with the urinary ACR in multiple stepwise regression analysis. The logistic multivariate regression analysis showed that the Hb level (OR: 0.936, 95% CI: 0.910-0.963, P < 0.001) was inversely correlated with DN in patients with T1DM. In sub-analysis, low Hb level (Hb < 120 g/L in female, Hb < 130 g/L in male) was still negatively associated with DN in patients with T1DM. The AUROC was 0.721 (95% CI: 0.655-0.787) in assessing the discrimination of the Hb level for DN. The value of P was 0.593 in Hosmer-Lemeshow goodness-of-fit test.

Conclusions: In patients with T1DM, the Hb level is inversely correlated with urinary ACR and DN.

Keywords: diabetic nephropathy; haemoglobin level; type 1 diabetes mellitus.