Maahs David M, Snively Beverly M, Bell Ronny A, Dolan Lawrence, Hirsch Irl, Imperatore Giuseppina, Linder Barbara, Marcovina Santica M, Mayer-Davis Elizabeth J, Pettitt David J, Rodriguez Beatriz L, Dabelea Dana
Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, P.O. Box 6511, Mail Stop A140, Aurora, CO 80045, USA.
Diabetes Care. 2007 Oct;30(10):2593-8. doi: 10.2337/dc07-0450. Epub 2007 Jul 13.
To estimate the prevalence of an elevated albumin-to-creatinine ratio (ACR) (> or = 30 microg/mg) among youth with type 1 or type 2 diabetes and to identify factors associated with elevated ACR and their effect on the relationship between elevated ACR and type of diabetes.
Cross-sectional data were analyzed from 3,259 participants with onset of diabetes at < 20 years of age in the SEARCH for Diabetes in Youth, a multicenter observational study of diabetes in youth. Multiple logistic regression was used to explore determinants of elevated ACR and factors accounting for differences in this prevalence between type 2 and type 1 diabetes.
The prevalence of elevated ACR was 9.2% in type 1 and 22.2% in type 2 diabetes (prevalence ratio 2.4 [95% CI 1.9-3.0]; P < 0.0001). In multiple logistic regression analysis, female sex, A1C and triglyceride values, hypertension, and type of diabetes (type 2 versus type 1) were significantly associated with elevated ACR. Adjustment for variables related to insulin resistance (obesity, hypertension, dyslipidemia, and inflammation) attenuated, but did not completely explain, the association of diabetes type with elevated ACR.
Youth with type 2 diabetes have a higher prevalence of elevated ACR than youth with type 1 diabetes, in an association that apparently does not completely depend on age, duration of diabetes, race/ethnicity, sex, level of glycemic control, or features of insulin resistance.
评估1型或2型糖尿病青年患者中白蛋白与肌酐比值（ACR）升高（≥30微克/毫克）的患病率，并确定与ACR升高相关的因素及其对ACR升高与糖尿病类型之间关系的影响。
对“青少年糖尿病研究（SEARCH for Diabetes in Youth）”中3259名20岁之前发病的糖尿病参与者的横断面数据进行分析，该研究是一项关于青少年糖尿病的多中心观察性研究。采用多因素logistic回归分析探讨ACR升高的决定因素以及2型和1型糖尿病在该患病率上存在差异的影响因素。
1型糖尿病患者中ACR升高的患病率为9.2%，2型糖尿病患者中为22.2%（患病率比值2.4 [95%置信区间1.9 - 3.0]；P < 0.0001）。在多因素logistic回归分析中，女性、糖化血红蛋白（A1C）和甘油三酯值、高血压以及糖尿病类型（2型与1型）与ACR升高显著相关。对与胰岛素抵抗相关的变量（肥胖、高血压、血脂异常和炎症）进行校正后，糖尿病类型与ACR升高之间的关联有所减弱，但并未完全消除。
2型糖尿病青年患者ACR升高的患病率高于1型糖尿病青年患者，这种关联显然并不完全取决于年龄、糖尿病病程、种族/民族、性别、血糖控制水平或胰岛素抵抗特征。
