Tabeya Tetsuya, Ohnishi Hirofumi, Saitoh Shigeyuki, Akasaka Hiroshi, Mitsumata Kaneto, Chiba Mizue, Furugen Makoto, Mori Mitsuru, Shimamoto Kazuaki
Sapporo Medical University School of Medicine.
Nihon Ronen Igakkai Zasshi. 2008 May;45(3):302-7. doi: 10.3143/geriatrics.45.302.
We investigated the relationship of metabolic syndrome (MetS) and insulin resistance (IR) with microalbuminuria in senior citizens of rural communities in Japan.
The subjects were 338 senior citizens (age 65 or older) who underwent medical examinations in the towns of Tanno and Sobetsu, Hokkaido in 2005. The following participants were excluded: those with missing data, those with type 2 diabetes (fasting plasma glucose >or=126 mg/dl and/or those who were on medication for diabetes), those who were on medication for hypertension and those with macroalbuminuria (urinary albumin creatinine ratio (ACR) >or=300 mg/g.Cr). The subjects were divided into two groups according to the Japanese criteria of MetS: a MetS group and a non-MetS group. The percentages of subjects with microalbuminuria (ACR >or=30 mg/g.Cr) in the two groups were compared. We also investigated the relationship between IR and microalbuminuria using homeostasis model assessment (HOMA-R).
The percentage of subjects with microalbuminuria was significantly higher in the MetS group than in the non-MetS group. Multiple logistic regression analysis showed that there was a significant relationship between MetS and microalbuminuria (relative risk: 3.09, 95%CI: 1.18-8.07) and that there was also a significant relationship between HOMA-R and microalbuminuria (relative risk: 1.91, 95%CI: 1.14-3.20).
It may be important for prevention of microalbuminuria in patients with MetS not only to manage blood pressure and blood glucose but also to manage IR, which is part of the background of accumulation of these risk factors.
我们研究了日本农村社区老年人中代谢综合征（MetS）和胰岛素抵抗（IR）与微量白蛋白尿之间的关系。
研究对象为2005年在北海道钏路市和留边蕊町接受体检的338名老年人（年龄65岁及以上）。排除以下参与者：数据缺失者、2型糖尿病患者（空腹血糖≥126mg/dl和/或正在接受糖尿病治疗者）、正在接受高血压治疗者以及大量白蛋白尿患者（尿白蛋白肌酐比值（ACR）≥300mg/g.Cr）。根据日本MetS标准将研究对象分为两组：MetS组和非MetS组。比较两组中微量白蛋白尿（ACR≥30mg/g.Cr）患者的百分比。我们还使用稳态模型评估（HOMA-R）研究了IR与微量白蛋白尿之间的关系。
MetS组中微量白蛋白尿患者的百分比显著高于非MetS组。多因素逻辑回归分析显示，MetS与微量白蛋白尿之间存在显著关系（相对风险：3.09，95%置信区间：1.18 - 8.07），HOMA-R与微量白蛋白尿之间也存在显著关系（相对风险：1.91，95%置信区间：1.14 - 3.20）。
对于MetS患者预防微量白蛋白尿而言，不仅控制血压和血糖很重要，控制作为这些危险因素积累背景一部分的IR也可能很重要。
