1170例体检者微量白蛋白尿分布状况调查

Investigation on the distribution status of microalbuminuria population in Qingdao area

目的探讨微量白蛋白尿(mieroalbuminuria,MAU)在不同代谢异常人群中分布情况,了解各危险因素对MAU的影响。方法 2012年青岛市城阳区人民医院参与青岛市慢性病流行病学调查,调查人群共4 650例,随机抽取1 170例为本课题的研究对象。所有研究对象留取晨尿测定尿微量白蛋白(urinary albumin,UAlb)和尿肌酐(urinary creatine,UCr),计算尿白蛋白与肌酐比值(urinary albumin creatine rate,UACR);根据UACR水平将研究对象分为对照组(UACR<30 mg/g)和MAU组(30 mg/g≤UACR<300 mg/g)。收集研究对象一般临床资料和测定生化指标,统计学处理采用SPSS 16.0软件。结果与对照组相比,MAU组的年龄、空腹血糖(fasting blood glucose,FBG)、舒张压(diastolic blood pressure,DBP)、收缩压(systolic blood pressure,SBP)、血清尿酸(serun urinary acid,SUA)、低密度脂蛋白(low-density lipoprotein cholesterol,LDL)、自然对数转换三酰甘油(triaeylglycerol,TG)、腰围(waist circumference,WC)、腰身比(waist to height ratio,WRS)、腰臀比(waist to hip ratio,WHR)均高于对照组,差异有统计学意义(P<0.05或P<0.01)。与对照组相比,MAU组高血糖(hyperglycemia,HG)、原发性高血压(primary hypertension,PHT)、血脂异常及肥胖,尤其腹型肥胖患病率升高,差异有统计学意义(P<0.05或P<0.01)。单纯HG、PHT、肥胖的MAU检出率分别为24.9%、17.2%、10.2%,HG合并PHT或肥胖的MAU检出率分别为38.7%、29.3%,PHT合并肥胖的MAU检出率为22.1%,代谢综合征(metabolic syndrome,MS)的MAU检出率为43.0%,患病风险分别为3.75倍、2.74倍、2.10倍、5.26倍、4.34倍、3.86倍及12.3倍。Logistic回归分析提示FBG、DBP、WSR、WC、WHR为MAU的危险因素,OR值分别为6.86、4.65、3.32、2.08和1.87。结论青岛地区MAU主要危险人群为HG、其次为PHT人群,再者为肥胖人群,尤其是腹型肥胖人群,危险因素聚集越多,MAU患病风险越高。

Objective To investigate the distribution status of microalbuminuria in abnormalities population of different metabolic and understand the contribution of different risk factors on microalbu- minutia. Methods In 2012, Chengyang District People＇s Hospital of Qingdao city participated in the epidemiological survey of chronic diseases （4 650 cases）, 1170 cases were randomly selected as the subjects of this study, urinary albumin and Urinary creatinine were randomly determined in the early morning, albumin creatine rate urinary （UACR） was calculated to evaluate the micro albumin urine in- dex. and according to the level of UACR, those were divided into.. Normal albumin urine group （NAU, male 398 cases, female 409 cases） and microalbuminuria group （MAU group, male 175 cases, female 188 cases）, the study subjects were collected the clinical data and biochemical indexes, statistical anal- ysis uses SPSS16. 0 software. Results （1） Compared with the NAU group, the MAUgroup, age, FBG, DBP, SBP, SUA, WC, WRS）, WHR was higher than that of the NAU group , the difference was statistically significant （P〈0. 05 or P〈0. 01） ; compared with the NAU group, high blood glu- cose, hypertension, dyslipidemia and obesity especially abdominal obesity prevalence rate of the NAU Group increased, the difference was statistically significant （P〈0. 05 or P〈0. 01） ; （2）Crosstable analysis results showed that urine albumin, high blood sugar, high blood pressure, simple obesity rates were 24. 9%, 17. 2%, 10. 2%, hyperglycemia and hypertension or urine albumin obesity rates were 38. 7%, 29. 3%, hypertension and obesity trace albumin urine detection rate was 22. 1%, Metabolic syndrome, urine albumin the rate was 43%, the risk was 3. 75, 2. 74, 2. 10, 5. 26, 4. 34, 3. 86 and 12. 3;（3）Logistic regression analysis DBP.WC.WSR.WHR.FBG were the risk factors of microalbu- minuria, The risk of FBG is the greatest, followed by high DBP, and high WSR and high WC, and fi- nally, the high WHR. The OR values were 6 386,4. 65, 3. 32, 2. 08 and 1.87. Conclusions The main risk population of MAU in Qingdao area was HG, followed by the PHT population, and also for the OB population, especially the AOB population, The more risk factors clustered, the higher the risk of MAU.