2型糖尿病者采用不同的MS诊断标准时伴有CKD风险的比较  

Compare the risk of chronic kidney disease adopting diffrent criterias for metabolic syndrom Metabolic syndrome in type 2 diabetes mellitus

作　　者：叶威巍[1] 鹿斌[1] 龚伟[1] 杨志红[1] 胡仁明[1] 

机构地区：[1]复旦大学附属华山医院内分泌科,上海200040

出　　处：《中国医疗前沿》2009年第5期1-2,共2页China Healthcare Innovation

基　　金：国家自然科学基金重点项目(30230380);上海市科委重大课题(04dz19504)

摘　　要：目的2型糖尿病人群采用不同的标准诊断代谢综合征(MS)时,伴有慢性肾脏病(CKD)风险的比较。方法上海中心城区整群抽样了1039例年龄在30岁以上、已诊断为2型糖尿病的患者。检测项目包括身高、体重、腰围、臀围、血压、血糖、血脂、尿白蛋白肌酐比。结果(1)依据中华糖尿病学会(CDS)诊断标准MS者占51.1,MS者中CKD的比例(56.7%)明显高于不伴有MS组(41.5%)(X2=23.121;P<0.01)。(2)采用不同的MS诊断标准,2型糖尿病合并MS人群的CKD的比例不同,由高至低依次为WHO(63.7%)、IDF(58.3%)、CDS(56.7%)、ATPⅢ(53.5%)(X2=14.359;P=0.002)。结论2型糖尿病患者采用WHO标准诊断MS时较其他标准,伴有CKD的风险较大。Objective This study aimed to compare the risk of chronic kidney disease （CKD） adopting diffrent criterias for metabolic syndrom Metabolic syndrome （MS） in type 2 diabetes mellitus .Methods We investigated 1039 patients diagnosed with type 2 diabetes aged over 30 by randomized cluster sampling in downtown Shanghai. Body measurements including height,weight, waist circumference,hip circumference,resting blood pressure, fasting blood measures were performed.Glomerular filtration rate （GFR） was estimated using the modified MDRD equations that were based on the Chinese patients with CKD. Results （1） The incidence of CKD was significantly greater in subjects with than without metabolic syndrome（56.7 % versus 41.5%; P〈0.01）. （2） The CKD prevalence ranged from63.7% （WHO）to 53.5% （ATP Ⅲ） when different diagnostic criteria for MS adopted（X^2= 14.359;P= 0.002）.Conclusions： WHO, but not the other definitions of MS, identifies a subgroup of patients who have a higher risk of CKD.

关 键 词：2型糖尿病 代谢综合征 慢性肾脏病 

分 类 号：R587.2[医药卫生—内分泌]