Wirta O R, Pasternack A I, Mustonen J T, Laippala P J, Reinikainen P M
Department of Medicine, Tampere University Hospital, Finland.
J Intern Med. 1999 Apr;245(4):329-35. doi: 10.1046/j.1365-2796.1999.00499.x.
To evaluate if urinary albumin excretion rate (UAER) is independently related to subclinical autonomic neuropathy in type 2 diabetes.
A controlled cross-sectional study.
Primary health care centre.
Consecutive recently diagnosed (< 1 year) type 2 diabetic patients (group A, n = 150) and patients with long-standing (median 11 years) type 2 diabetes (group B, n = 146) chosen at random. A nondiabetic control group (group C, n = 150) matched for age and gender to group A.
Neuropathy by cardiovascular reflex tests and UAER by nephelometry.
Univariate statistics in group A + B (t-test chi 2- or McNemars test) with Valsalva and breathing ratios as categorical grouping variables and the independent variables gender, smoking, systolic and diastolic blood pressure, fasting serum cholesterol, HDL cholesterol, triglycerides, haemoglobin A1c, glucagon stimulated C-peptide, fasting and postload 1 and 2 h blood glucose and serum insulin, UAER, coronary heart disease and congestive heart failure. Logistic regression analyses in group A + B with Valsalva and breathing ratios as dependent categorical variables and age, systolic blood pressure, congestive heart failure, coronary heart disease, fasting blood glucose, serum triglycerides and UAER as independent variables.
Compared to nondiabetic subjects the diabetic patients of both groups were at increased risk of neuropathy as judged by the Valsalva ratio (P < 0.01). In known diabetic patients with a UAER > or = 30 mg 24-1 h neuropathy was more common than amongst their normoalbuminuric counterparts (Valsalva test P = 0.007, breathing test P = 0.02). In logistic regression analysis UAER independently explained abnormal Valsalva (P = 0.015) and breathing tests (P = 0.04) in the group A + B.
UAER is independently related to subclinical autonomic neuropathy in type 2 diabetes.
评估尿白蛋白排泄率（UAER）是否与2型糖尿病亚临床自主神经病变独立相关。
对照横断面研究。
初级卫生保健中心。
连续入选的近期诊断（<1年）的2型糖尿病患者（A组，n = 150）和病程较长（中位数11年）的2型糖尿病患者（B组，n = 146）。一个年龄和性别与A组匹配的非糖尿病对照组（C组，n = 150）。
通过心血管反射试验评估神经病变，通过散射比浊法测定UAER。
在A组+B组中进行单变量统计（t检验、卡方检验或McNemar检验），将瓦尔萨尔瓦动作和呼吸比率作为分类分组变量，自变量包括性别、吸烟、收缩压和舒张压、空腹血清胆固醇、高密度脂蛋白胆固醇、甘油三酯、糖化血红蛋白、胰高血糖素刺激的C肽、空腹及负荷后1小时和2小时血糖及血清胰岛素、UAER、冠心病和充血性心力衰竭。在A组+B组中进行逻辑回归分析，将瓦尔萨尔瓦动作和呼吸比率作为因分类变量，年龄、收缩压、充血性心力衰竭、冠心病、空腹血糖、血清甘油三酯和UAER作为自变量。
与非糖尿病受试者相比，两组糖尿病患者根据瓦尔萨尔瓦比率判断的神经病变风险均增加（P < 0.01）。在已知糖尿病患者中，UAER≥30 mg/24 h者神经病变比尿白蛋白正常者更常见（瓦尔萨尔瓦试验P = 0.007，呼吸试验P = 0.02）。在逻辑回归分析中，UAER在A组+B组中独立解释了异常的瓦尔萨尔瓦动作（P = 0.015）和呼吸试验（P = 0.04）。
UAER与2型糖尿病亚临床自主神经病变独立相关。
