Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Spain.
Clin Sci (Lond). 2013 Feb;124(4):269-77. doi: 10.1042/CS20120261.
The present study was undertaken to examine the prevalence of urinary ACR (albumin/creatinine ratio) >30 mg/g and the associated clinical and environmental factors in a representative sample of the population of Spain. Di@bet.es study is a national, cross-sectional population-based survey conducted in 2009-2010. Clinical, metabolic, socio-demographic, anthropometric data and information about lifestyle habit were collected. Those subjects without KDM (known diabetes mellitus) were given an OGTT (oral glucose tolerance test). Albumin and creatinine were measured in a urinary sample and ACR was calculated. The population prevalence of ACR >30 mg/g was 7.65% (adjusted for sex and age). The prevalence of ACR >30 mg/g increased with age (P<0.001). Subjects with carbohydrate metabolism disorders had a greater prevalence of ACR >30 mg/g but after being adjusted for age, sex and hypertension, was significant only in those subjects with UKDM (unknown diabetes mellitus) {OR (odd ratio), 2.07 [95% CI (confidence interval), 1.38-3.09]; P<0.001] and KDM [OR, 3.55 (95% CI, 2.63-4.80); P<0.001]. Prevalence of ACR >30 mg/g was associated with hypertension [OR, 1.48 (95% CI, 1.12-1.95); P=0.001], HOMA-IR (homoeostasis model assessment of insulin resistance) [OR, 1.47 (95% CI, 1.13-1.92); P≤0.01], metabolic syndrome [OR, 2.17 (95% CI, 1.72-2.72); P<0.001], smoking [OR, 1.40 (95% CI, 1.06-1.83); P≤0.05], physical activity [OR, 0.68 (95% CI, 0.54-0.88); P≤0.01] and consumption of fish [OR, 0.38 (95% CI, 0.18-0.78); P≤0.01]. This is the first study that reports the prevalence of ACR >30 mg/g in the Spanish population. The association between clinical variables and other potentially modifiable environmental variables contribute jointly, and sometimes interactively, to the explanation of prevalence of ACR >30 mg/g. Many of these risk factors are susceptible to intervention.
本研究旨在调查西班牙代表性人群中尿 ACR（白蛋白/肌酐比值）>30mg/g 的患病率，以及相关的临床和环境因素。Di@bet.es 研究是 2009-2010 年进行的一项全国性、横断面、基于人群的调查。收集了临床、代谢、社会人口统计学、人体测量学数据以及生活方式习惯信息。对那些没有 KDM（已知糖尿病）的人进行 OGTT（口服葡萄糖耐量试验）。在尿样中测量白蛋白和肌酐，并计算 ACR。ACR>30mg/g 的人群患病率为 7.65%（性别和年龄调整后）。ACR>30mg/g 的患病率随年龄增长而增加（P<0.001）。患有碳水化合物代谢紊乱的患者 ACR>30mg/g 的患病率更高，但在调整年龄、性别和高血压后，仅在 UKDM（未知糖尿病）患者中具有统计学意义{OR（比值比），2.07[95%CI（置信区间），1.38-3.09]；P<0.001]和 KDM[OR，3.55（95%CI，2.63-4.80）；P<0.001]。ACR>30mg/g 的患病率与高血压[OR，1.48（95%CI，1.12-1.95）；P=0.001]、HOMA-IR（胰岛素抵抗稳态模型评估）[OR，1.47（95%CI，1.13-1.92）；P≤0.01]、代谢综合征[OR，2.17（95%CI，1.72-2.72）；P<0.001]、吸烟[OR，1.40（95%CI，1.06-1.83）；P≤0.05]、体力活动[OR，0.68（95%CI，0.54-0.88）；P≤0.01]和鱼类消费[OR，0.38（95%CI，0.18-0.78）；P≤0.01]相关。这是第一项报告西班牙人群中 ACR>30mg/g 患病率的研究。临床变量与其他潜在可改变的环境变量之间的关联共同作用，有时还会相互作用，共同解释 ACR>30mg/g 的患病率。这些危险因素中有许多易于干预。
