乌鲁木齐市某社区白蛋白尿检出率及危险因素分析

Detection rate and risk factors of albuminuria in a community of Urumqi

目的了解新疆乌鲁木市某社区白蛋白尿的检出率,探讨其相关影响因素。方法2013年5月采用横断面研究整群随机抽样方法抽取乌鲁木齐1222名常住居民,并用统一调查表记录研究对象的糖尿病病程、高血压病程,测定其BMI、腹围、收缩压、舒张压、空腹血糖、糖化血红蛋白、血脂、尿白蛋白/肌酐比值(ACR)水平,按照ACR水平分为大量白蛋白尿组(>300 mg/g)、微量白蛋白尿组(30-300 mg/g)和尿白蛋白正常组(<30 mg/g),并进行组间血糖、血脂等水平的比较。结果乌鲁木齐某社区18-83岁1222人ACR阳性的检出率为9.81%,其中男性为7.96%,女性为10.68%;大量白蛋白尿组和微量白蛋白尿组的检出率分别为0.81%和8.51%(P<0.05)。多因素回归分析显示收缩压、舒张压、空腹血糖、血脂、糖化血红蛋白、糖尿病病程、高血压病程是人群中发生蛋白尿的独立危险因素。结论人群中白蛋白尿检出率高,尤其是糖尿病、高血压、高脂血症者是蛋白尿高危人群,提醒我们要及时关注白蛋白尿形成的相关危险因素,及早进行干预。

Objective To understand the detection rate of albuminuria in a community of Urumqi,Xinjiang,and to explore its related influencing factors.Methods In May 2013,1222 permanent residents in Urumqi were selected by cluster random sampling.The course of diabetes and hypertension were recorded with unified questionnaire,and the levels of BMI,abdominal circumference,systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin,blood lipid and urinary albumin/creatinine ratio(ACR)were measured.According to the ACR level,the subjects were divided into the macroalbuminuria group(>300 mg/g),the microalbuminuria group(30-300 mg/g)and the normal urinary albumin group(<30 mg/g)The levels of blood glucose and blood lipid were compared between the two groups.Results The positive rate of ACR was 9.81%in 1222 people aged 18-83 years in a community of Urumqi,including 7.96%in males and 10.68%in females;the positive rates of the macroalbuminuria group and the microalbuminuria group were 0.81%and 8.51%,respectively(P<0.05).Multivariate regression analysis showed that systolic blood pressure,diastolic blood pressure,fasting blood glucose,blood lipids,glycosylated hemoglobin,duration of diabetes and duration of hypertension were independent risk factors for proteinuria.Conclusions The detection rate of albuminuria in the population is high,especially diabetes,hypertension and hyperlipidemia are high-risk groups of albuminuria,which reminds us to pay attention to the related risk factors of albuminuria formation in time and carry out intervention as soon as possible.