Unnikrishnan Ranjit I, Rema Mohan, Pradeepa Rajendra, Deepa Mohan, Shanthirani Coimbatore Subramaniam, Deepa Raj, Mohan Viswanathan
Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, 4 Conran Smith Rd., Gopalapuram, Chennai, 600 086, India.
Diabetes Care. 2007 Aug;30(8):2019-24. doi: 10.2337/dc06-2554. Epub 2007 May 8.
The aim of this study was to determine the prevalence of diabetic nephropathy among urban Asian-Indian type 2 diabetic subjects.
Type 2 diabetic subjects (n = 1,716), inclusive of known diabetic subjects (KD subjects) (1,363 of 1,529; response rate 89.1%) and randomly selected newly diagnosed diabetic subjects (NDD subjects) (n = 353) were selected from the Chennai Urban Rural Epidemiology Study (CURES). Microalbuminuria was estimated by immunoturbidometric assay and diagnosed if albumin excretion was between 30 and 299 microg/mg of creatinine, and overt nephropathy was diagnosed if albumin excretion was > or = 300 microg/mg of creatinine in the presence of diabetic retinopathy, which was assessed by stereoscopic retinal color photography.
The prevalence of overt nephropathy was 2.2% (95% CI 1.51-2.91). Microalbuminuria was present in 26.9% (24.8-28.9). Compared with the NDD subjects, KD subjects had greater prevalence rates of both microalbuminuria with retinopathy and overt nephropathy (8.4 vs. 1.4%, P < 0.001; and 2.6 vs. 0.8%, P = 0.043, respectively). Logistic regression analysis showed that A1C (odds ratio 1.325 [95% CI 1.256-1.399], P < 0.001), smoking (odds ratio 1.464, P = 0.011), duration of diabetes (1.023, P = 0.046), systolic blood pressure (1.020, P < 0.001), and diastolic blood pressure (1.016, P = 0.022) were associated with microalbuminuria. A1C (1.483, P < 0.0001), duration of diabetes (1.073, P = 0.003), and systolic blood pressure (1.031, P = 0.004) were associated with overt nephropathy.
The results of the study suggest that in urban Asian Indians, the prevalence of overt nephropathy and microalbuminuria was 2.2 and 26.9%, respectively. Duration of diabetes, A1C, and systolic blood pressure were the common risk factors for overt nephropathy and microalbuminuria.
本研究旨在确定亚洲印度裔城市2型糖尿病患者中糖尿病肾病的患病率。
从金奈城乡流行病学研究（CURES）中选取2型糖尿病患者（n = 1716），包括已知糖尿病患者（KD患者）（1529例中的1363例；应答率89.1%）和随机选取的新诊断糖尿病患者（NDD患者）（n = 353）。通过免疫比浊法估算微量白蛋白尿，若白蛋白排泄量在30至299微克/毫克肌酐之间则诊断为微量白蛋白尿，若在存在糖尿病视网膜病变的情况下白蛋白排泄量≥300微克/毫克肌酐则诊断为显性肾病，糖尿病视网膜病变通过立体视网膜彩色摄影进行评估。
显性肾病的患病率为2.2%（95%可信区间1.51 - 2.91）。微量白蛋白尿的患病率为26.9%（24.8 - 28.9）。与NDD患者相比，KD患者合并视网膜病变的微量白蛋白尿和显性肾病的患病率更高（分别为8.4%对1.4%，P < 0.001；2.6%对0.8%，P = 0.043）。逻辑回归分析显示，糖化血红蛋白（比值比1.325 [95%可信区间1.256 - 1.399]，P < 0.001）、吸烟（比值比1.464，P = 0.011）、糖尿病病程（1.023，P = 0.046）、收缩压（1.020，P < 0.001）和舒张压（1.016，P = 0.022）与微量白蛋白尿相关。糖化血红蛋白（1.483，P < 0.0001）、糖尿病病程（1.073，P = 0.003）和收缩压（1.031，P = 0.004）与显性肾病相关。
研究结果表明，在亚洲印度裔城市居民中，显性肾病和微量白蛋白尿的患病率分别为2.2%和26.9%。糖尿病病程、糖化血红蛋白和收缩压是显性肾病和微量白蛋白尿的常见危险因素。
