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青少年糖尿病患者的出生体重[校正后]及白蛋白与肌酐比值升高:青少年糖尿病研究(SEARCH)

Birth weight [corrected] and elevated albumin to creatinine ratio in youth with diabetes: the SEARCH for Diabetes in Youth study.

作者信息

Maahs David M, Snively Beverly M, Beyer Jennifer, Imperatore Giuseppina, Bell Ronny, Mayer-Davis Elizabeth J, Dolan Lawrence M, Pettitt David J, Hirsch Irl, Rodriguez Beatriz, Dabelea Dana

机构信息

Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, CO, USA,

出版信息

Pediatr Nephrol. 2008 Dec;23(12):2255-60. doi: 10.1007/s00467-008-0921-z. Epub 2008 Jul 8.

Abstract

Low birth weight (BWT) may contribute to kidney disease and could explain some of the variance in the development of early diabetic kidney disease. This hypothesis was tested in the multicenter SEARCH study (3,714 youth with diabetes <20 years of age). A morning spot urine sample, laboratory and anthropometric data, and a medical history were obtained. Elevated albumin to creatinine ratio (ACR) was defined as > or =30 mcg albumin/mg creatinine, and BWT was categorized as low (<2,500 g), reference (2,500-4,000 g), or high (>4,000 g). The relationship of BWT to elevated ACR was analyzed using multiple logistic regression. In youth with diabetes, the prevalence of elevated ACR was 12.6% in those with low BWT, 9.7% in those with reference BWT, and 8.9% in those with high BWT. BWT category was not significantly associated with elevated ACR (p = 0.23). Those with diabetes duration >18 months (2,032) had the following association of BWT category with elevated ACR [odds ratio (OR) = 1.64, 95% confidence interval (CI) 1.00-2.69, p = 0.0503] for low BWT compared with reference BWT. Whereas low BWT may be a factor in kidney disease, little evidence was found of a relationship between low BWT and elevated ACR in this study population of youth with diabetes.

摘要

低出生体重(BWT)可能会导致肾脏疾病,并且可以解释早期糖尿病肾病发展过程中的一些差异。这一假设在多中心SEARCH研究(3714名20岁以下的糖尿病青少年)中得到了验证。研究获取了早晨的随机尿样、实验室检查及人体测量数据,以及病史。白蛋白与肌酐比值(ACR)升高定义为≥30微克白蛋白/毫克肌酐,出生体重被分为低体重(<2500克)、参照体重(2500 - 4000克)或高体重(>4000克)。使用多因素逻辑回归分析出生体重与ACR升高之间的关系。在患有糖尿病的青少年中,低出生体重者ACR升高的患病率为12.6%,参照体重者为9.7%,高出生体重者为8.9%。出生体重类别与ACR升高无显著相关性(p = 0.23)。在糖尿病病程>18个月的患者(2032名)中,与参照体重相比,低出生体重者ACR升高的相关性如下[比值比(OR)= 1.64,95%置信区间(CI)1.00 - 2.69,p = 0.0503]。虽然低出生体重可能是肾脏疾病的一个因素,但在该糖尿病青少年研究人群中,几乎没有证据表明低出生体重与ACR升高之间存在关联。

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