Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Clin J Am Soc Nephrol. 2010 Jun;5(6):1015-20. doi: 10.2215/CJN.08841209. Epub 2010 Mar 18.
Many African Americans (AA) have both sickle cell trait (SCT) and diabetes mellitus. The objective of this study was to determine whether individuals with diabetes mellitus and SCT have higher rates of microvascular complications relative to those without SCT.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a retrospective study comparing albuminuria, estimated GFR (eGFR), and microvascular complications in AA with diabetes on the basis of presence of SCT. The study included 821 outpatients who underwent hemoglobin A1c (HbA1c) testing, and presence of SCT was determined using the HbA1c assay. Medical record review and telephone interviews were performed for AA participants.
Data were obtained on 376 AA patients (110 with SCT, 245 with neither SCT nor hemoglobin C trait, and 21 with hemoglobin C trait) and 445 European Americans. The mean eGFR and urinary protein excretion were similar between the three AA subgroups. Analysis revealed that 36.3% of AA nontrait and 22.7% of AA SCT participants had retinopathy, peripheral vascular disease, or end-stage kidney disease (P = 0.01). After adjustment for diabetes duration, age, insulin use, and gender, differences in the prevalence of microvascular complications were not observed.
SCT does not increase the risk of microvascular complications in AA with diabetes mellitus.
许多非裔美国人（AA）同时患有镰状细胞特征（SCT）和糖尿病。本研究旨在确定是否患有糖尿病和 SCT 的个体相对于无 SCT 的个体发生微血管并发症的风险更高。
设计、地点、参与者和测量：这是一项回顾性研究，根据是否存在 SCT，比较了 AA 中糖尿病患者的蛋白尿、估算肾小球滤过率（eGFR）和微血管并发症。该研究纳入了 821 名接受血红蛋白 A1c（HbA1c）检测的门诊患者，使用 HbA1c 检测法确定 SCT 的存在。对 AA 参与者进行了病历回顾和电话访谈。
获得了 376 名 AA 患者（110 名存在 SCT，245 名既不存在 SCT 也不存在血红蛋白 C 特征，21 名存在血红蛋白 C 特征）和 445 名欧洲裔美国人的数据。三个 AA 亚组的平均 eGFR 和尿蛋白排泄量相似。分析显示，36.3%的非 SCT AA 患者和 22.7%的 SCT AA 患者患有视网膜病变、外周血管疾病或终末期肾病（P=0.01）。在调整糖尿病病程、年龄、胰岛素使用和性别后，未观察到微血管并发症发生率的差异。
SCT 不会增加 AA 中糖尿病患者微血管并发症的风险。
