探讨诊断微量白蛋白尿在非糖尿病人群的性别特异性切点

Analysis of sex specific criteria of microalbuminuria in non-diabetic population

目的分析非糖尿病人群尿白蛋白与肌酐比值(ACR)的测定结果之间的性别差异,为中国制定诊断微量白蛋白尿的性别特异性标准提供参考数据。方法对北京石景山地区中老年人群进行流行病学调查,无糖尿病者行口服75g葡萄糖耐量试验(OGTT),同时进行问卷调查并对体检的1580例非糖尿病完整资料进行统计,分析ACR的性别差异及原因。结果非糖尿病人群中,男性尿肌酐浓度显著高于女性(8.1vs5.5mmol/L,P<0.05);男性ACR显著低于女性(2.6vs3.1mg/g,P<0.05)。正常血糖(NGT)人群、糖调节受损(IGR)人群及合并后的非糖尿病人群中男性ACR的95%正常上限均为23mg/g,女性ACR的95%正常上限分别为27、32和28mg/g。结论过夜晨尿(次尿)测定ACR诊断不同性别微量白蛋白尿确实存在差异,不同性别应采用不同的诊断标准。

Objective To analyze the sex specific characters of albumin/creatinine ratio （ACR） in non-diabetes population, and to provide reference data for determining the sex-specific criteria of microalburninuria. Methods A total of 1580 non-diabetes adults who passed the 75g oral glucose tolerance test, were included in present study. All of them answered questionnaire and undertook physical examination. All data were analyzed for the sex difference in ACR, and its causes were looked for. Results In the non-diabetes population, the concentration of urine creatinine was significantly higher in males than that in females （8. 1 vs 5. 5mmol/L, P〈0. 05）, and the ACR was significantly lower in males than that in females （2. 6 vs 3. 1mg/g, P〈0. 05）. In the normal glucose tolerance （NGT）, impaired glucose regulation （IGR） and non-diabetes population, the 95% upper normal limit of ACR was 23mg/g in all males, and was 27mg/g, 32mg/g and 28mg/g respectively in females. Conclusion There is sex difference in ACR for the diagnosis of microalbuminuria, so sex-specific criteria should be used.