新诊断2型糖尿病患者微量白蛋白尿的患病率及危险因素分析

目的探讨新诊断2型糖尿病（T2DM）患者微量白蛋白尿（MAU）的患病率及其相关危险因素。方法对285例新诊断的T2DM患者进行回顾性分析,其中男173例,女112例。按尿微量白蛋白/肌酐比值（ACR）分为单纯糖尿病组（DM组）和伴微量白蛋白尿组（DM＋MAU组）,分别观察体重指数（BMI）、腰臀比（WHR）、血糖、血脂、血压、胰岛素抵抗指数（HOMA-IR）等因素的组间差异及其与ACR关系。结果新诊断的T2DM患者MAU的患病率为26.7%。男女患病率分别为24.85%和29.46%,不同性别ACR患病率无统计学差异;2组比较,DM＋UAER组BMI、WHR、HbA1c、FPG、SBP、DBP、TC、TG、HOMA-IR均高于DM组;相关分析显示,ACR与WHR、BMI、HOMA-IR、SBP、HbA1c呈正相关;多因素Logistic回归分析显示WHR、SBP和HbA1c是影响ACR的主要危险因素。结论应重视T2DM患者尿白蛋白的早期筛查,早期严格控制血糖、血压,纠正脂代谢紊乱,减轻腹型肥胖,有助于延缓和控制糖尿病肾病的发生及发展。

Prevalence and risk factor analysis of microalbuminuria in patients with newly diagnosed type 2 diabetes mellitus

Objective To explore the prevalence and its risk factors of microalbuminuria in patients with newly diagnosed type 2 diabetic mellitus（T2DM）.Methods A retrospective analysis of 285 patients（173 males,112 females） with newly diagnosed T2DM was conducted.Based on the ratio of microalbuminuria and creatinine,the patients were divided into diabetic group（DM group） and diabetic plus microalbuminuria group（DpM group）.Body mass index （BMI）,waist-hip ratio（WHR）,blood glucose,blood lipids,blood pressure,insulin resistance index（HOMA-IR） and other factors were observed for group differences and their relation to microalbuminuria/creatinine ratio.Results Microalbuminuria prevalence of patients with newly diagnosed T2DM was 26.7%.Prevalence rates in male and female were 24.85% and 29.46% respectively.There was no difference in prevalence of microalbuminuria between different genders.The values of BMI,WHR,HbA1c,FPG,SBP,DBP,TC,TG,and HOMA-IR were higher in the DpM group than in the DM group.The correlation analysis showed that the ACR was positively correlated with WHR,BMI,HOMA-IR,SBP,and HbA1c.Logistic regression analysis showed that WHR,SBP and HbA1c were major risk factors affecting the ACR.Conclusion Attention should be paid to the early screening of T2DM patients with urinary albumin.Early strict control of blood sugar and blood pressure,correction of lipid metabolism disorders and reduction of abdominal obesity help to slow down and control the development and progression of diabetic nephropathy.