2型糖尿病患者正常范围尿白蛋白与肌酐比值和高血压风险的相关性研究  

Association Between the Ratio of Urinary Albumin to Creatinine in Normal Range and Risk of New Onset Hypertension in Patients With Type 2 Diabetes

作　　者：康静 李洮俊 方团育[3] 袁晓丹[4] 宋润珞[5] 楼青青 KANG Jing;LI Yaojun;FANG Tuanyu;YUAN Xiaodan;SONG Runluo;LOU Qingqing(The College of Nursing,Henan University of Science and Technology,Luoyang(471003),Henan,China)

机构地区：[1]河南科技大学护理学院,河南省洛阳市471003 [2]中国台湾李氏联合诊所 [3]海南省人民医院内分泌科 [4]南京中医药大学附属中西医结合医院健康教育科 [5]河南科技大学第一附属医院神经内科 [6]海南医学院第一附属医院内分泌科

出　　处：《中国循环杂志》2022年第6期609-614,共6页Chinese Circulation Journal

基　　金：国家重点研发计划“战略性科技创新合作”重点专项港澳台项目(2021YFE0204800)。

摘　　要：目的:评估2型糖尿病患者正常范围尿白蛋白与肌酐比值(urine albumin-to-creatinine ratio,UACR)与高血压风险的相关性。方法:本研究纳入1309例中国台湾李氏联合诊所定期随访的2型糖尿病患者,随访3~12年(平均6年)。根据UACR的四分位数水平将患者分为第1分位组即UACR<5.87 mg/g组(n=320)、第2分位组即5.87 mg/g≤UACR≤9.55 mg/g组(n=341)、第3分位组即9.56 mg/g≤UACR≤16.27 mg/g组(n=321)和第4分位组即16.27 mg/g<UACR<30.00 mg/g组(n=327)。分析正常范围内UACR水平和2型糖尿病患者新发高血压风险的关系。结果:UACR<5.87 mg/g组、5.87 mg/g≤UACR≤9.55 mg/g组、9.56 mg/g≤UACR≤16.27 mg/g组和16.27 mg/g<UACR<30.00 mg/g组高血压的发病率分别为71.3%(228/320)、77.4%(264/341)、82.9%(266/321)和80.4%(263/327),四组比较差异有统计学意义(P<0.05)。在校正基线年龄、性别、糖尿病病程、用药情况、糖化血红蛋白水平等因素后,Cox回归分析发现,与UACR<5.87 mg/g组相比,5.87 mg/g≤UACR≤9.55 mg/g组、9.56 mg/g≤UACR≤16.27 mg/g组、16.27 mg/g<UACR<30.00 mg/g组高血压的HR(95%CI)分别为1.075(0.896~1.289)、1.024(0.853~1.230)、1.215(1.010~1.462),趋势检验P值为0.018。结论:2型糖尿病患者正常范围内的UACR与高血压的发病风险呈正相关。Objectives:To assess the association of normal range urine albumin-to-creatinine ratio(UACR)and the risk of new onset hypertension in patients with type 2 diabetes.Methods:The study included 1309 patients with type 2 diabetes who were regularly followed up for 3 to 12 years(mean 6 years)at Lee's United Clinic in Taiwan,China.According to the quartile level of UACR,the patients were divided into the first quartile group(UACR<5.87 mg/g);the second quartile group(5.87 mg/g≤UACR≤9.55 mg/g);the third quartile group(9.56 mg/g≤UACR≤16.27 mg/g)and the fourth quartile group(16.27 mg/g<UACR<30.00 mg/g).The association between normal UACR levels and the risk of new onset of hypertension in patients with type 2 diabetes mellitus was analyzed.Results:The incidence of new onset hypertension in the first to fourth quartile groups showed a significant upward trend,71.3%(228/320),77.4%(264/341),82.9%(266/321)and 80.4%(263/327)from the first to fourth quartile groups,respectively,and the difference was statistically significant(P<0.05).After adjusted for baseline age,sex,duration of diabetes,medication,glycosylated hemoglobin level and other factors,Cox regression analysis showed that compared with the first quartile group,the relative risks(95%confidence limits)of new onset hypertension in the second,third and fourth quartile groups were 1.075(0.896-1.289),1.024(0.853-1.230)and 1.215(1.010-1.462),respectively(Ptrend=0.018).Conclusions:The UACR value within the normal range is positively correlated with the risk of new onset of hypertension in patients with type 2 diabetes.

关 键 词：高血压 蛋白尿 尿白蛋白与肌酐比值 2型糖尿病 

分 类 号：R541.4[医药卫生—心血管疾病]