2型糖尿病患者慢性肾脏病和蛋白尿的相关性分析

Association between urine albumin to creatinine ratio and chronic kidney disease in type 2 diabetic patients

目的:探讨2型糖尿病(DM2)患者中1、2级慢性肾脏病(CKD1、CKD2)和蛋白尿的相关性。方法:对591例(男性:438例;女性:153例)DM2人群进行和断面调查。采用简化MDRD公式估算肾小球滤过率(eGFR)划分CKD1和CKD2。通过随机尿中白蛋白与肌酐比值(ACR,mg/g)确定蛋白尿。结果:CKD1组无蛋白尿、微量蛋白尿、大量蛋白尿的发生率分别为78.9%、18.1%和3.0%,CKD2组分别为63.4%、24.8%和11.8%。控制年龄、性别、糖尿病病程、体重指数、血压、血脂、空腹血糖和糖化血红蛋白,Logistic回归分析显示,微量蛋白尿较无蛋白尿的糖尿病患者发生CKD2危险性的OR(95%CI)值是3.06(1.19-7.84)倍;大量蛋白尿较无蛋白尿的糖尿病患者发生CKD2危险性的OR值是6.00(2.43-14.78)倍。结论:蛋白尿与CKD的发展联系紧密,是CKD1发展为CKD2的独立危险因素。

Objective：The aim of this study was to explore the relationship between chronic kidney disease（stage 1 and stage 2,CKD1 and CKD2） and urine albumin to creatinine ratio（ACR） in type 2 diabetic patients.Methods： A total of 591 type 2 diabetic patients（438 men,153women） were enrolled in the cross-sectional survey.The CKD was divided into CKD1 and CKD2 according to the estimated estimating Glomerular Filtration Rate（eGFR）calculated by the MDRD study equation.Random Urine samples were examined for urine albumin secretion based on an ACR.Results： The prevalence rate of normoalbuminuric,microalbuminuric and macroalbuminuric were 78.9%、18.1% and 3.0% in CKD1,and were 63.4%、24.8% and 11.8% in CKD2,respectively.After adjustment for age,gender,duration of diabetes,body mass index,blood lipids,blood pressure,blood glucose and glycated hemoglobin,the ORs（95% CI） for CKD2 compared microalbuminuric with normoalbuminuric was 3.06（1.19-7.84）,and compared macroalbuminuric with normoalbuminuric was 3.06（1.19-7.84）,respectively.Conclusion： ACR was closely associated with the development of CKD,and was an independent risk factor for the development from CKD1 to CKD2.