Krairittichai Udom, Potisat Somkiat, Jongsareejit Amporn, Sattaputh Charnvate
Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Mar;94 Suppl 2:S6-10.
Testing for microalbuminuria (MA) is an important tool for detection of the earliest clinical manifestation of diabetic nephropathy Dipstick test for MA is commonly used for screening MA but this dipstick test has not been validated in Thai patients with DM.
To evaluate the diagnostic accuracy of the dipstick test for MA in random spot urine samples of type 2 diabetic mellitus patients, using urinary albumin to creatinine ratio (UACR) as the reference standard method.
Type 2 diabetic mellitus patients from the out-patient department of seven public hospitals were recruited. Random spot urine samples from all patients were screened for microalbuminuria by Combi-Screen dipstick test and UACR.
A total of 6,223 urine samples from 899 diabetic patients were screened for MA. From UACR criteria, these urine samples were classified as normoalbuminuria (4,016 samples, 64.5%), MA (1,795 samples, 28.8%) and macroalbuminuria (412 samples, 6.6%). The dipstick test for MA had an overall sensitivity of 83.7%, specificity of 92.6% with a positive predictive value of 83.4% and a negative predictive value of 92.7%. The area under the receiver operating characteristics curve of the dipstick test for MA is 0.9427.
The dipstick test for MA may be a useful method to initially screen for MA in Thai patients with type 2 DM.
微量白蛋白尿（MA）检测是糖尿病肾病最早临床表现检测的重要工具。MA试纸条检测常用于筛查MA，但该试纸条检测在泰国糖尿病患者中尚未得到验证。
以尿白蛋白肌酐比值（UACR）作为参考标准方法，评估2型糖尿病患者随机尿样中MA试纸条检测的诊断准确性。
招募七家公立医院门诊的2型糖尿病患者。通过Combi-Screen试纸条检测和UACR对所有患者的随机尿样进行微量白蛋白尿筛查。
共对899例糖尿病患者的6223份尿样进行了MA筛查。根据UACR标准，这些尿样被分类为正常白蛋白尿（4016份样本，64.5%）、MA（1795份样本，28.8%）和大量白蛋白尿（412份样本，6.6%）。MA试纸条检测的总体敏感性为83.7%，特异性为92.6%，阳性预测值为83.4%，阴性预测值为92.7%。MA试纸条检测的受试者工作特征曲线下面积为0.9427。
MA试纸条检测可能是泰国2型糖尿病患者初步筛查MA的有用方法。
