天津市某社区老年人群白蛋白尿发生率分布状况调查  

Investigation of the distribution of the prevalence of albuminuria in community elderly population in Tianjin

作　　者：郑晓莉[1] 王华斌[2] 刘蕊[1] 孙遨 崔小璠[1] 姜旭[1] Zheng Xiaoli Wang Huabin Liu Rui Sun Ao Cui Xiaofan J iang Xu(Laboratory Department, Tianjin Union Medical Center, Tianj in 300121 , China （ Zheng XL , Liu R, Cui XF Graduate School of Tianjin Medical University, Tianj in 300070 ,China（Wang HB ,J iang X Department of Clinical Laboratory, Tianjin J unliangcheng Hospital, Vianjin, 300301 , China （Sun A)

机构地区：[1]天津市人民医院检验学部,300121 [2]天津医科大学研究生院,300070 [3]天津市东丽区军粮城医院检验科,300301

出　　处：《中华老年医学杂志》2016年第12期1334-1338,共5页Chinese Journal of Geriatrics

摘　　要：目的对天津市某社区居住老年人群进行白蛋白尿发生率分布状况调查，并分析。肾脏早期损伤情况及可能存在的临床及生活习性的风险因素。方法收集天津市某社区居住的60岁以上2050例体检老年人清晨尿液标本及其相关体检资料，检测尿白蛋白浓度和尿肌酐浓度，计算白蛋白／肌酐比值（ACR），统计人群中白蛋白尿发生率，并用Logistic回归分析其影响因素的风险比（OR）。结果2050例受试者中1162例（56．69％）患有高血压，264例（12．86％）患有糖尿病，ACR升高者占568例（27．71％）。男性ACR〉30mg／g者占21．55％，女性占32．58％，男性白蛋白尿发生率显著低于女性（OR=0．58，P〈0．05）；不同年龄组人群，70～79岁人群ACR升高风险是60～69岁人群的1．45倍，大于80岁人群则是1．89倍，调整性别因素后，大于80岁人群ACR升高风险则增长至2．03倍。排除性别、年龄因素后，体质指数和腰围对ACR水平均没有明显影响，但三酰甘油、高血压、糖尿病则是ACR升高的危险因素（OR=1．19、1．68、1．95）。每日吸烟量的增加，会导致ACR水平升高，但对ACR的风险影响差异无统计学意义。运动频率增加能降低ACR水平，特别是在运动频率为1次／d时，较不运动人群而言能显著降低白蛋白尿的发生风险（OR=0．52，P=0．027）。结论该社区老年人群中，存在较高的白蛋白尿发生率，女性多于男性；其中高血压、糖尿病是最大的危险因素，然而1次／d的运动能够降低白蛋白尿发生的风险。Objective To investigate the distribution of the prevalence of albuminuria in elderly population of a community in Tianjin and analyze the situation of their early renal injury and its clinical and environmental risk factors. Methods The morning spot urine sample and the clinical data from 2 050 old population （aged ≥ 60 years）who took part in healthy examination were collected. The concentration of urine albumin and creatinine were tested, and the albumin/creatinine ratio（ACR）was calculated. We analyzed the prevalence of albuminuria, and used logistic regression to analyze the odd ratio（OR） of risk factors. Results In the 2 050 participants, the prevalence was 1162 cases （56.69%） for hypertension, 264 cases （12.86%） for diabetes and 568 cases （27.71Z%） for albuminuria. The prevalence of ACR 〉 30 mg/g was lower in men than in women （21.61% vs. 32. 550/00 ,P〈0. 001）. The OR for increased ACR was 1.45 in 70 79y subjects as compared with 60- 69y subjects,and the OR was 1.89 in 〉80y old people. The OR of increased ACR was 2.03 in 〉80y old people after adjusting gender. Body mass index and waist circumference were not the risk factors of increased ACR after adjusting confounding factors. There was an association between the prevalence of albuminuria and triglycerides （OR= 1.19 ）, hypertension（OR = 1.68）, diabetes （ OR = 1.95 ）. ACR value was increased along with increased number of cigarettes, however, there was also no association between smoking and albuminuria（P〉0.05）. Physical activity could reduce the risk of albuminuria, the OR of ACR〉 30 mg/g in those undertaking a activity once daily was 0.52 （P = 0. 027）Conclusions There is a high prevalence of albuminuria in elderly population（higher in female than in male） in a community of Tianjin. Hypertension and diabetes have the greatest influence on ACR. Additionally,the physical activity once daily can reduce the risk of albuminuria.

关 键 词：白蛋白尿 危险因素 

分 类 号：R446.12[医药卫生—诊断学] R696.2[医药卫生—临床医学]