Cederholm J, Eliasson B, Nilsson P M, Weiss L, Gudbjörnsdottir S
Family Medicine and Epidemiology Section, Department of Public Health and Caring Sciences, Dag Hammarskjolds vag 14B, University Hospital, Uppsala SE-75185, Sweden.
Diabetes Res Clin Pract. 2005 Mar;67(3):258-66. doi: 10.1016/j.diabres.2004.07.021.
A prospective study of normoalbuminuric diabetic patients was performed between 1997 and 2002 on 4097 type 1 and 6513 type 2 diabetic patients from the Swedish National Diabetes Register (NDR); mean study period, 4.6 years. The strongest independent baseline risk factors for the development of microalbuminuria (20-200 microg/min) were elevated HbA(1c) and diabetes duration in both types 1 and 2 diabetic patients. Other risk factors were high BMI, elevated systolic and diastolic BP in type 2 patients, and antihypertensive therapy in type 1 patients. A subsequent larger cross-sectional study in 2002 showed that established microalbuminuria was independently associated with HbA(1c), diabetes duration, systolic BP, BMI, smoking and triglycerides in types 1 and 2 diabetic patients, and also with HDL-cholesterol in type 2 patients. Relatively few types 1 and 2 patients with microalbuminuria achieved treatment targets of HbA(1c) < 6.5% (21-48%), BP < 130/85 mmHg (33-13%), cholesterol < 5 mmol/l (48-46%), triglycerides < 1.7 mmol/l (83-48%) and BMI < 25 kg/m(2) (50-18%), respectively. In conclusion, high HbA(1c), BP and BMI were independent risk factors for the development of microalbuminuria in types 1 and 2 diabetic patients. These risk factors as well as triglycerides, HDL-cholesterol and smoking were independently associated with established microalbuminuria. Treatment targets were achieved by a relatively few patients with microalbuminuria.
1997年至2002年间，对瑞典国家糖尿病登记处（NDR）的4097例1型糖尿病患者和6513例2型糖尿病患者进行了一项关于正常白蛋白尿糖尿病患者的前瞻性研究；平均研究期为4.6年。1型和2型糖尿病患者发生微量白蛋白尿（20 - 200微克/分钟）的最强独立基线危险因素是糖化血红蛋白（HbA1c）升高和糖尿病病程。其他危险因素包括2型患者的高体重指数（BMI）、收缩压和舒张压升高，以及1型患者的抗高血压治疗。2002年随后进行的一项更大规模的横断面研究表明，已确诊的微量白蛋白尿与1型和2型糖尿病患者的HbA1c、糖尿病病程、收缩压、BMI、吸烟和甘油三酯独立相关，在2型患者中还与高密度脂蛋白胆固醇（HDL - 胆固醇）相关。相对较少的1型和2型微量白蛋白尿患者达到了糖化血红蛋白<6.5%（21% - 48%）、血压<130/85 mmHg（33% - 13%）、胆固醇<5 mmol/l（48% - 46%）、甘油三酯<1.7 mmol/l（83% - 48%）和BMI<25 kg/m²（50% - 18%）的治疗目标。总之，高HbA1c、血压和BMI是1型和2型糖尿病患者发生微量白蛋白尿的独立危险因素。这些危险因素以及甘油三酯、HDL - 胆固醇和吸烟与已确诊的微量白蛋白尿独立相关。只有相对较少的微量白蛋白尿患者达到了治疗目标。
