加勒比地区2型糖尿病患者的贫血与肾功能不全
Anaemia and kidney dysfunction in Caribbean type 2 diabetic patients.
作者信息
Ezenwaka Chidum E, Jones-Lecointe Altheia, Nwagbara Emeka, Seales Dawn, Okali Fidelis
机构信息
Unit of Pathology & Microbiology, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago.
出版信息
Cardiovasc Diabetol. 2008 Aug 27;7:25. doi: 10.1186/1475-2840-7-25.
BACKGROUND
Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome.
METHODS
155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were measured and fasting blood samples were collected for glucose, creatinine, glycated hemoglobin and complete blood count. Anaemia was defined as haemoglobin < 12 g/dl (F) or < 13 g/dl (M). Kidney function was assessed using glomerular filtration rate (GFR) as estimated by the four-variable Modification of Diet in Renal Disease (MDRD) study equation. Subjects were considered to have chronic kidney disease when the estimated GFR was < 60 ml/min per 1.73 m2. Comparisons for within- and between-gender, between diabetic and non-diabetic subjects were performed using Student's t-test while chi-square test was employed for categorical variables.
RESULTS
The diabetic patients were older than the non-diabetic subjects. While male non-diabetic subjects had significantly higher red blood cell count (RBC), haemoglobin and hematocrit concentrations than non-diabetic female subjects (p < 0.001), the RBC and hematocrit concentrations were similar in male and female diabetic patients. Furthermore, irrespective of gender, diabetic patients had significantly higher prevalence rate of anemia than non-diabetic subjects (p < 0.05). Anaemic diabetes patients had significantly lower GFR (67.1 +/- 3.0 vs. 87.9 +/- 5.4 ml/min per 1.73 m2, p < 0.001) than non-anaemic patients.
CONCLUSION
A high prevalence of anaemia was identified in this group of type 2 diabetic patients previously shown to have a high prevalence of the metabolic syndrome. It is therefore recommended that diagnostic laboratories in developing countries and elsewhere should include complete blood count in routine laboratory investigations in the management of diabetic patients.
背景
先前的研究表明，贫血是患有慢性肾脏疾病的糖尿病患者发生心血管疾病的一个危险因素。本研究旨在评估加勒比地区2型糖尿病患者中贫血和肾功能不全的患病率，此前已表明该地区代谢综合征的患病率很高。
方法
对155例2型糖尿病患者和51例非洲裔非糖尿病受试者进行了研究。测量人体测量参数，并采集空腹血样检测血糖、肌酐、糖化血红蛋白和全血细胞计数。贫血定义为血红蛋白<12 g/dl（女性）或<13 g/dl（男性）。使用四变量肾脏疾病饮食改良（MDRD）研究方程估算的肾小球滤过率（GFR）评估肾功能。当估算的GFR<60 ml/（min·1.73 m²）时，受试者被认为患有慢性肾脏病。使用Student's t检验对性别内和性别间、糖尿病患者和非糖尿病受试者之间进行比较，而分类变量则采用卡方检验。
结果
糖尿病患者比非糖尿病受试者年龄更大。男性非糖尿病受试者的红细胞计数（RBC）、血红蛋白和血细胞比容浓度显著高于非糖尿病女性受试者（p<0.001），而男性和女性糖尿病患者的RBC和血细胞比容浓度相似。此外，无论性别如何，糖尿病患者的贫血患病率均显著高于非糖尿病受试者（p<0.05）。贫血的糖尿病患者的GFR（67.1±3.0 vs. 87.9±5.4 ml/（min·1.73 m²），p<0.001）显著低于非贫血患者。
结论
在这组先前已表明代谢综合征患病率很高的2型糖尿病患者中，发现贫血患病率很高。因此，建议发展中国家和其他地区的诊断实验室在糖尿病患者的管理中，应将全血细胞计数纳入常规实验室检查。
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