糖尿病前期患病率及影响肾小球滤过率相关因素分析

Prevalence and factors contributing to estimated glomerular filtration rate in prediabetes

目的估算糖尿病前期患病率,探讨糖尿病前期患者中影响肾小球滤过率的相关因素。方法选取2008年1月至2009年1月于青岛内分泌糖尿病医院健康查体的4040人作为研究对象,其中男性1544人,女性2496人。根据血糖水平诊断糖尿病前期,计算其患病率。收集研究对象的一般临床资料及实验室检查数据。采用多重线性回归分析糖尿病前期人群人体测量学指标及代谢指标与肾小球滤过率的相关关系。糖尿病前期诊断标准根据2010年美国糖尿病协会诊断标准,即空腹血糖5.6~6.9mmol/L或餐后2h血糖7.8~11.0mmol/L。应用CKD-EPI公式计算肾小球滤过率。结果糖尿病前期患病率为44.5%,其中男性患病率为47.6%,女性患病率为42.6%(P<0.05)。收缩压、舒张压、腰围、腰身比、腰臀比、甘油三酯、总胆固醇、口服葡萄糖耐量2h血糖、血尿酸与糖尿病前期患者的肾小球滤过率呈负相关关系。结论青岛地区糖尿病前期患病率较高。血尿酸水平较其他代谢指标更能反映肾小球滤过率水平,更适合用于评估肾脏功能。

Objective To estimate the prevalence of prediabetes,and investigate the impact factors of estimated glomerular filtration rate in prediabetes.Methods The total 4040 subjects came from people in physical examinations of Qingdao Endocrine and Diabetes Hospital from January2008 to January 2009,with 1544 males and 2496 females.Based on glucose from the diagnosis of prediabetes,the prevalence of prediabetes was calculated.The clinical data and testing data from subjects were collected.The multiliner regression model was used to analyze the relationship between the estimated glomerular filtration rate and data,which included anthropometric and metabolic index in prediabetes.The diagnosis of prediabetes was based on standards by the America Diabetes Association in 2010:when the fasting blood glucose level is 5.6-6.9mmol/L(impaired fasting glucose=IFG)or when the 2-hour postprandial blood glucose level is 7.8-11.0 mmol/L(impaired glucose tolerance=IGT).The Chronic Kidney Disease Epidemiology Collaboration formula was used to calculate the estimated glomerular filtration rate.Results The prevalence of prediabetes was 44.5%,47.6% for male and 42.6% for female(P<0.05).Factors including systolic blood pressure,diastolic blood pressure,waistline,hipline,waist-hip ratio,waist-height ratio,triglyceride,total cholesterol and blood uric acid had negative correlation with estimated glomerular filtration rate in prediabetes.Conclusion The prevalance of prediabetes in Qingdao is high.The blood uric acid is better than other metabolic index to reflect estimated glomerular filtration rate and estimate renal function.