Taleb Nadine, Salti Haytham, Al-Mokaddam Mona, Merheb Marie, Salti Ibrahim, Nasrallah Mona
Department of Internal Medicine, Endocrinology, American University of Beirut, Beirut, Lebanon.
Ann Saudi Med. 2008 Nov-Dec;28(6):420-5. doi: 10.5144/0256-4947.2008.420.
Few data are available on the extent of albuminuria in diabetic populations in the Middle East generally and in Lebanon specifically. We conducted this study to determine the prevalence of albuminuria and its major risk factors in a cohort of diabetic patients in Lebanon.
Diabetic patients followed in the outpatient department at the American University of Beirut Medical Center (AUBMC) were included in a prospective observational study. AUBMC is a tertiary referral center and the outpatient department typically handles patients of low socioeconomic status with advanced disease. Patients were classified according to their urinary albumin-to-creatinine ratio (ACR) as having normoalbuminuria (ACR<30 mg/g creatinine), microalbuminuria (ACR=30 to <300 mg/g creatinine), or macroalbuminuria (ACR > or =300 mg/g creatinine). The three groups were compared to analyze the association between albuminuria and its risk factors. In addition, independent predictors of albuminuria were determined using multivariate logistic regression and presented as an odds ratio.
Microalbuminuria and macroalbuminuria were present in 33.3% and 12.7% of 222 patients (mean age 56.4 years, mean deviation of diabetes 8.6 years, 58.7% women, 43.8% obese), respectively. Factors significantly associated with microalbuminuria included glycemic control, insulin use, and total and LDL cholesterol. Those associated with macroalbuminuria included in addition to glycemic control and insulin use, duration of diabetes, hypertension, elevated mean arterial pressure (MAP), and presence of neuropathy, retinopathy and peripheral vascular disease by bivariate analysis. Only glycemic control was an independent risk factor for both in addition to MAP and retinopathy for macroalbuminuria by multivariate analysis.
Albuminuria is highly prevalent among this cohort of diabetic patients in Lebanon. Both glycemic control and blood pressure need to be better targeted in its management.
关于中东地区糖尿病患者蛋白尿程度的数据普遍较少,黎巴嫩的情况尤其如此。我们开展这项研究以确定黎巴嫩一组糖尿病患者中蛋白尿的患病率及其主要危险因素。
在贝鲁特美国大学医学中心(AUBMC)门诊随访的糖尿病患者被纳入一项前瞻性观察性研究。AUBMC是一家三级转诊中心,门诊通常接待社会经济地位较低且患有晚期疾病的患者。根据尿白蛋白与肌酐比值(ACR)将患者分类为正常白蛋白尿(ACR<30mg/g肌酐)、微量白蛋白尿(ACR = 30至<300mg/g肌酐)或大量白蛋白尿(ACR≥300mg/g肌酐)。比较这三组以分析蛋白尿与其危险因素之间的关联。此外,使用多变量逻辑回归确定蛋白尿的独立预测因素,并以比值比表示。
222例患者(平均年龄56.4岁,糖尿病平均病程8.6年,58.