微量白蛋白尿在不同糖代谢异常人群中的患病率及危险因素分析

目的 比较糖耐量正常（NGT）、糖调节受损（IGR）、2型糖尿病（T2DM）三种不同糖代谢状态人群的微量白蛋白尿患病率,探讨微量白蛋白尿的危险因素。方法根据75g口服葡萄糖耐量试验（OGTT）的结果,将1779例受检者分为：NGT组752例、IGR组505例、T2DM组522例。所有受检者以速率散射比浊法测定晨尿白蛋白,并以尿白蛋白／肌酐（ACR）表示尿白蛋白排泄率,ACR在30-300mg／g诊断为微量白蛋白尿。结果 （1）NGT组有35例诊断为微量白蛋白尿,患病率为4．7％;IGR组有31例,患病率6．1％;T2DM组有59例,患病率11．3％,显著高于NGT组和IGR组（P〈0．01）。（2）Logistic回归分析显示,微量白蛋白尿的独立危险因素为收缩压、OGTT2h血糖和甘油三酯。结论T2DM病人微量白蛋白尿的患病率显著升高。收缩压、餐后血糖及甘油三酯与微量白蛋白尿的出现密切相关。

Prevalence and predictors of microalbuminuria in persons with various glucose tolerance levels

OBJECTIVE: To investigate the prevalence of microalbuminuria in persons with various glucose tolerance levels and the risk factors for the development of microalbuminuria. METHODS: Early morning urine samples were collected from 1,779 subjects with all the data necessary for this survey from a population screened in Baoshan Community, Shanghai by cluster sampling, including 752 with normal glucose tolerance (NGT), 505 impaired glucose tolerance (IGR), and 522 type 2 diabetes mellitus (T2DM) diagnosed according to a 75 g oral glucose tolerance test (OGTT). Urinary albumin-to-creatinine ratio (ACR) was measured by rate-nephelometry method. RESULTS: (1) The incidence rate of MAU of the T2DM group was 11.3%, significantly higher than those of the NGT and IGR groups (4.7% and 6.1% respectively, both P < 0.01). (2) Logistic regression showed that MAU was significantly correlated with 2 h PG, systolic blood pressure, and triglyceride. CONCLUSION: The prevalence of MAU is significantly higher in the diabetic patients. 2 h PG, systolic blood pressure, and triglyceride and independent risk factors of MAU.