Department of Endocrinology, Ministry of Public Health Beijing Hospital, Beijing Dongdan Dahua Street No 1, Beijing 100730, People's Republic of China.
Acta Diabetol. 2012 Dec;49 Suppl 1:S65-71. doi: 10.1007/s00592-010-0205-5. Epub 2010 Jul 1.
UNLABELLED: The objective of this study is to investigate the correlation of urinary albumin excretion rate (UAER) with the incidence of coronary heart disease (CHD), pathological characteristics and severity of coronary atherosclerosis in patients with type 2 diabetes mellitus (T2DM), and explore the efficacy of using the urinary albumin excretion rate (UAER) to predict the risk of CHD in patients with T2DM. The study included 1,004 T2DM patients with normo- and micro-albuminuria who underwent coronary angiography for suspected coronary atherosclerosis. The severity of coronary atherosclerosis was defined using the Gensini's score system. The correlation of UAER with the incidence of CHD, pathological characteristic and the severity of coronary atherosclerosis in patients with T2DM was analyzed. The best numerical value of UAER in predicting the risk of CHD in patients with T2DM was calculated. The differences in sex, age, BMI, SBP, history of smoking, duration of diabetes mellitus, HbA1C, FPG, LDL-C, HDL-C, Cre, Uric acid, HOMA-IR between microalbuminuria(MAU) subgroup and normal albuminuria subgroup were statistically significant(P < 0.05). The differences in the incidence of CHD, the number of pathological coronary vessels, the Gensini's score and LVEF% between microalbuminuria group and normal albuminuria group were statistically significant (P < 0.05). UAER increased significantly with an increase in the number of pathological coronary vessels. Logistic multiple regression analysis showed that UAER was independently correlated with the incidence of CHD (OR = 1.092, P = 0.000, 95% CI = 1.063-1.122). Spearman's correlation analysis showed that the Gensini's score was significantly positively correlated with UAER, sex, age, BMI, SBP, the history of smoking and drinking, the duration of diabetes mellitus, HbA1c, FPG, PPG, LDL-C, Cre, C-reactive protein (CRP), uric acid (UA). Based on the ROC curve, the 11.275 μg/min of UAER was the best numerical value to predict the risk of CHD in patients with T2DM. Area under the curve was 0.799, sensitivity was 65.1%, and specificity was 82.9%. CONCLUSION: Microalbuminuria in patients with T2DM is another risk factor for CHD. Microalbuminuria is significantly positively correlated with the severity of coronary atherosclerosis. An UAER value of 11.275 μg/min can be used to predict the risk of CHD in patients with T2DM.
目的：本研究旨在探讨尿白蛋白排泄率（UAER）与 2 型糖尿病（T2DM）患者冠心病（CHD）发生率、冠状动脉粥样硬化病理特征及严重程度的相关性，探讨利用 UAER 预测 T2DM 患者 CHD 风险的疗效。
方法：本研究纳入 1004 例经冠状动脉造影怀疑冠状动脉粥样硬化的 T2DM 伴正常白蛋白尿和微量白蛋白尿患者。采用 Gensini 评分系统定义冠状动脉粥样硬化严重程度。分析 UAER 与 T2DM 患者 CHD 发生率、病理特征和冠状动脉粥样硬化严重程度的相关性。计算 UAER 预测 T2DM 患者 CHD 风险的最佳数值。
结果：与正常白蛋白尿亚组相比，微量白蛋白尿（MAU）亚组的性别、年龄、BMI、SBP、吸烟史、糖尿病病程、HbA1C、FPG、LDL-C、HDL-C、Cre、尿酸、HOMA-IR 差异有统计学意义（P < 0.05）。与正常白蛋白尿组相比，微量白蛋白尿组 CHD 发生率、病变冠状动脉支数、Gensini 评分和 LVEF%差异有统计学意义（P < 0.05）。随着病变冠状动脉支数的增加，UAER 显著升高。Logistic 多因素回归分析显示，UAER 与 CHD 发生率独立相关（OR = 1.092，P = 0.000，95%CI = 1.063-1.122）。Spearman 相关分析显示，Gensini 评分与 UAER、性别、年龄、BMI、SBP、吸烟和饮酒史、糖尿病病程、HbA1c、FPG、PPG、LDL-C、Cre、C 反应蛋白（CRP）、尿酸（UA）呈显著正相关。基于 ROC 曲线，UAER 为 11.275μg/min 时预测 T2DM 患者 CHD 风险的最佳数值。曲线下面积为 0.799，敏感度为 65.1%，特异度为 82.9%。
结论：T2DM 患者微量白蛋白尿是 CHD 的又一危险因素。微量白蛋白尿与冠状动脉粥样硬化严重程度呈显著正相关。UAER 值为 11.275μg/min 可用于预测 T2DM 患者 CHD 风险。
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013-11
Clin Nephrol. 1992
Diabetes Metab Syndr Obes. 2020-12-18
Int J Environ Res Public Health. 2018-7-4
J Diabetes Metab Disord. 2015-9-14
World J Diabetes. 2014-8-15
Int J Clin Exp Med. 2013-10-25
Zotero 插件