不同糖代谢人群中微量清蛋白尿患病率及影响因素调查分析  

Prevalence and Influencing Factors of Microalbuminuria in People with Various Glucose Tolerances

作　　者：刘慧慧[1] 甄东户[1] 郭晓颖 汤旭磊[1] 赵楠[1] 

机构地区：[1]兰州大学第一医院内分泌科,甘肃省兰州市730000 [2]兰州市城关区五泉铁路西村街道社区卫生服务中心

出　　处：《中国全科医学》2013年第15期1747-1751,共5页Chinese General Practice

基　　金：中华医学会临床医学科研专项资金(10020120234);甘肃省卫生行业科技计划(GSWST2010-03)

摘　　要：目的调查糖耐量正常(NGT)、糖调节受损(IGR)、2型糖尿病(T2DM)3种不同糖代谢状态人群的微量清蛋白尿(MAU)患病率,探讨MAU的相关影响因素。方法采用整群随机抽样方法,2011年5—9月对兰州市城关区五泉铁路西村社区2 960名≥40岁居民进行问卷调查,并测其身高、体质量、腰围(WC)、臀围、血压、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、血脂、MAU、尿肌酐水平。多因素Logistic回归分析IGR和T2DM人群MAU的影响因素。结果男、女IGR、T2DM患病率均随着年龄的增长而逐步升高(IGR男、女P趋势值分别为0.016和<0.0001;T2DM男、女P趋势值均<0.0001)。男、女IGR标化患病率比较,差异无统计学意义(χ2=-0.924,P=0.283);男性T2DM标化患病率高于女性,差异有统计学意义(χ2=16.25,P=0.0006)。2 960名调查对象MAU标化患病率在NGT组(1 665例)、IGR组(682例)及T2DM组(623例)中分别为5.4%、8.1%、19.5%,3组比较差异有统计学意义(χ2=112.514,P<0.001);其中IGR组和T2DM组均高于NGT组,差异有统计学意义(χ2=5.574,P=0.018;χ2=35.61,P<0.001);T2DM组高于IGR组,差异有统计学意义(χ2=19.28,P<0.001)。IGR人群男性MAU标化患病率高于女性(9.0%与7.7%,χ2=2.16,P<0.01)。伴或不伴MAU的IGR及T2DM患者除低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)水平及饮酒外,余临床指标比较,差异均有统计学意义(P<0.05)。IGR伴MAU组人群WC、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)高于IGR组,运动水平低于IGR组,差异均有统计学意义(P<0.05);T2DM伴MAU组人群T2DM病程、体质指数(BMI)、WC、腰臀比(WHR)、SBP、DBP、FPG、2 hPG、HbA1c均高于T2DM组,差异有统计学意义(P<0.05)。未使用和使用不同降糖药物的T2DM患者MAU患病率比较,差异有统计学意义(P<0.05);两种或两种以上药物联合(包括联合胰岛素)、胰岛素、促进胰岛素分泌剂(磺脲类及非磺脲类)人群较未使用药物人群MAU患病率增高,差异均有统计学意义(P<Objective To explore the prevalence of microalbuminuria （MAU） in persons with normal glucose toter- ante （NGT）, impaired glucose regulation （IGR） and type 2 diabetes mellitus （T2DM） and to investigate the risk factors of MAU. Methods A random sampling was conducted in Lanzhou Wuquantieluxieun community with a representative sample of 2 960 adults aged above 40 years. Questionnaire was conducted. Height, weight, waist circumference （ WC ）, hip circumfer- ence, blood pressure, fasting plasma glucose （FPG）, 2 -hour postprandial plasma glucose （2 hPG）, blood lipid, MAU and urine ereatinine were detected. Multiple Logistic regression analysis was conducted to analyze influencing factors of MAU in IGR and T2DM people. Results The prevalence of IGR and T2DM in male and female increased with age （IGR： P = 0. 016 in male and P 〈0. 0001 in female; T2DM： both P 〈0. 0001 in male and female） . There was no significant difference in the prevalence of IGR among male and female （X2 = -0. 924, P =0. 283） . However, the incidence of T2DM in male was significantly higher than that of the female （X2 = 16. 25, P =0. 0006） . Of the 2 960 subjects, age - standardized prevalence of MAU in NGT group （n = 1 665）, IGR group （n =682） and T2DM group （n =623） was 5.4%, 8.1% and 19. 5% respectively, and the differ-ences were statistically significant in these groups （X2 = 112. 514, P 〈 0. 001 ） . Compared with NGT group, IGR group and T2DM group had a significantly higher prevalence of MAU （X2 = 5. 574, P = 0. 018 ; X2 = 35.61, P 〈 0. 001 ） ; T2DM group had significantly higher prevalence of MAU compared with IGR group （X2 = 19.28, P 〈0. 001 ） . Male had a significantly higher ,9（2 prevalence of MAU in IGR group （9. 0% versus 7.7 % ; = 2. 16, P 〈 0. 01 ） With the exception of LDL - C, TC or drink- ing, in IGR and T2DM groups with or without MAU, there were significant differences in other statistical indexes （ P 〈 0.05 ）. Among IGR population, WC, SBP,

关 键 词：糖尿病 2型 糖调节受损 清蛋白尿 危险因素 

分 类 号：R587.1[医药卫生—内分泌]