人体测量学肥胖指标与微量白蛋白尿的相关性研究

目的 探讨人体测量学肥胖指标与微量白蛋白尿(microalbuminuria,MAU)的相关性.方法 在青岛市城阳区人民医院2012年流行病学调查数据库中收集调查人群1170例,留取清晨随机尿测定尿微量白蛋白(urinary albumin,UAlb)和尿肌酐(urinary creatine,UCr),计算比值(urinary albumin creatine rate,UACR)并根据UACR水平分为:正常白蛋白尿组(nornal albumin urine,NAU)(807例)和MAU组(363例),收集人体测量学指标和测定生化指标,作统计学处理.结果 ①与NAU组相比,MAU组年龄、空腹血糖(fasting blood glucose,FBG)、舒张压(diastolic blood pressure,DBP)、收缩压(systolic blood pressure,SBP)、血清尿酸(serun urinary acid,SUA)、腰围(waist circumference,WC)、腰身比(Waist to height ratio,WTHR)、腰臀比(Waist to hip ratio,WHR)均高于前者,差异有统计学意义(P＜0.05或P＜0.01);与NAU组相比,MAU 组高血糖(hyperglycemia,HG)、原发性高血压(primary hypertension,PHT)、血脂异常(dyslipidemia,DLP)及OB,尤其腹型肥胖(abdominal obesity,AOB)患病率升高,差异有统计学意义(P＜0.05或P＜0.01);②多元线性回归分析显示,对MAU贡献大小依次WTHR＞ WC＞ WHR;③采用受试者工作特征曲线(ROC)分析男性人群WTHR、WHR、WC等预测MAU的曲线下面积依次为0.68(95％CI:0.67 ～ 0.70)、0.64(95％ CI:0.62 ～0.65)、0.57 (95％ CI:0.55～0.59),预测切点0.52、0.90、91.8 cm.在女性人群中,WSR、WC、WHR等预测MAU的曲线下面积依次为0.71(95％CI:0.70～0.72)、0.69 (95％ CI:0.68～0.70)和0.64(95％ CI:O.62 ～0.65),预测切点0.52、0.84、82.5 cm.结论 ①AOB为MAU的高危人群;②WTHR为最佳预测指标,切点为0.52,其次为WC和WHR,男性切点分别为89.6 cm和0.88 cm,女性为84.5 cm和0.84 cm.

Study on the correlation between anthropometric obesity index and microalbuminuria

Objectives To investigate the correlation between anthropometric obesity index and microalbuminuria (MAU).Methods Clinical data of 1170 cases were collected in the epidemiological survey database in 2012 chengyang district people's hospital of qingdao city.Urinary albumin(UAlb),urinary creatinine(UCr) and urinary albumin creatine rate(UACR) were randomly determined in the early morning,albumin creatine rate urinary (UACR) was calculated,,All patients were divided into normal albumin urine group (NAU group,398 males,409 femals) and microalbuminuria group (MAU group,175 males,188 females) according to the level of UACR.Anthropometric indexes and biochemical indexes were statistically analysed.Results ①Compared with the NAU group,age,fasting blood glucose(FBG),diastolic blood pressure (DBP),systolic blood pressure (SBP),serun urinary acid(SUA),waist circumference(WC),waist to height ratio(WTHR),waist to hip ratio (WHR) of the MAU group were higher than those of the NAU group,the difference was statistically significant (P ＜ 0.05 or P ＜ 0.01).Compared with the NAU group,high blood glucose,hypertension,dyslipidemia and obesity especially abdominal obesity prevalence rate of the NAU group increased,the difference was statistically significant (P ＜ 0.05 or P ＜ 0.01).②Multiple linear regression analysis was carried,the contribution to MAU was WTHR ＞ WC ＞ WHR in turn.③By Using the receiver operating characteristic curve (ROC) analysis,in male population,the predictive MAU area under the curve of WTHR,WHR,WC was 0.68 (95％CI:0.67 ～0.70),0.64 (95％ CI:0.62 ～0.65),0.57 (95％CI:0.55 ～0.59),respectively.Predictive point was 0.52,0.90,91.8 cm.,in female population,the predictive MAU area under the curve of WTHR,WHR,WC was 0.71 (95 ％ CI:0.70 ～ 0.72),0.69 (95 ％ CI:0.68 ～ 0.70) and 0.64 (95 ％ CI:0.62 ～ 0.65),respectively.Predictive point was 0.52,0.84,82.5 cm.Conclusions ① The AOB population is a high-risk group of MAU.②WTHR is the best predictor,and cut-off point is 0.52,secondly WC and WHR,men are 89.6 cm and 0.88cm,women are 84.5 cm and 0.84 cm.