糖尿病前期患者发生微量白蛋白尿风险的巢式病例对照研究

Nested case-control study of the risk of microalbuminuria in prediabetic population

目的探讨DM前期患者发生微量白蛋白尿的影响因素。方法选取2011年8~12月参加REACTION研究的大连地区40岁以上、基线为DM前期患者1236例,根据随访时UACR水平分为UACR≥30 mg/g组(n=206)和UACR<30 mg/g组(n=1030)。比较两组一般资料及生化指标,Logistic回归分析DM前期患者UACR的影响因素。结果UACR≥30 mg/g组BMI、SBP、DBP、谷丙转移酶、谷草转移酶、FIns、胰岛素抵抗指数(HOMA-IR)、血尿酸、睡眠时间异常患病率、高血压病患病率高于UACR<30 mg/g组(P<0.05)。Logistic回归分析結果显示,高血压病史、SBP、HOMA-IR及睡眠时间异常是DM前期患者UACR的危险因素。结论高血压病史、SBP、HOMA-IR及睡眠时间异常是DM前期患者发生微量白蛋白尿的危险因素。

Objective To investigate the influencing factors for microproteinuria in people with prediabetes.Methods Subjects with prediabetes who were over 40 years old and participated in the REACTION study in Dalian from August 2011 to December 2011 were enrolled in this study.All the participants were divided into two groups:UACR≥30 mg/g group(n=206)and UACR<30 mg/g group(n=1030)during follow-up.General characteristics were compared between the two groups.Logistic regression analysis was used to explore risk factors for microalbuminuria in prediabetic population.Results Compared with the UACR<30 mg/g group,BMI,SBP,DBP,ALT,AST,FIns,HOMA-IR,SUA,abnormal sleep time,and prevalence of hypertension were increased in UACR≥30 mg/g group(P<0.05).Logistic regression analysis showed that,hypertension history,SBP,HOMA-IR and abnormal sleep time were independent risk factors for microalbuminuria in prediabetes patients.Conclusion The hypertension history,SBP,HOMA-IR and abnormal sleep time are the risk factors for microalbuminuria in prediabetes patients.