Collins V R, Dowse G K, Finch C F, Zimmet P Z, Linnane A W
World Health Organization Collaborating Centre for the Epidemiology of Diabetes Mellitus, Lions-International Diabetes Institute, Melbourne, Australia.
Diabetes. 1989 Dec;38(12):1602-10. doi: 10.2337/diab.38.12.1602.
Rates of elevated urinary albumin concentration, defined as microalbuminuria (30-299 micrograms/ml) and macroalbuminuria (greater than or equal to 300 micrograms/ml), were determined on random morning urine specimens in the population of Nauru, which has a high prevalence of non-insulin-dependent diabetes mellitus. The prevalence of elevated urinary albumin levels in the total Nauruan population was very high: 26 and 30% of men and women, respectively, had microalbuminuria, whereas 13% of both sexes had macroalbuminuria. Of the subjects with macroalbuminuria, 66% had diabetes. The prevalence increased with worsening glucose tolerance; 26% of subjects with normal glucose tolerance had either micro- or macroalbuminuria, increasing to 43% of subjects with impaired glucose tolerance, 63% of newly diagnosed diabetic subjects, and 75% of previously diagnosed diabetic subjects. Associations between elevated urinary albumin concentration and putative risk factors were assessed for both the total population (n = 1184) and the diabetic subgroup alone (n = 318). Fasting plasma glucose and hypertension were the most important independent correlates for the whole population, whereas plasma creatinine was also important in diabetic subjects. Age at onset and duration of diabetes were not found to be significantly associated with elevated albumin concentration. In subjects with normal glucose tolerance, hypertension and hyperuricemia were the most important associated factors. These results suggest that blood glucose, blood pressure, and possibly obesity and plasma uric acid are important modifiable risk factors for both micro- and macroalbuminuria in this population.
在瑙鲁人群中，对随机晨尿样本测定了尿白蛋白浓度升高的发生率，尿白蛋白浓度升高定义为微量白蛋白尿（30 - 299微克/毫升）和大量白蛋白尿（大于或等于300微克/毫升），该人群中非胰岛素依赖型糖尿病患病率很高。瑙鲁总人口中尿白蛋白水平升高的患病率非常高：男性和女性中分别有26%和30%患有微量白蛋白尿，而两性中均有13%患有大量白蛋白尿。在患有大量白蛋白尿的受试者中，66%患有糖尿病。患病率随着糖耐量恶化而增加；糖耐量正常的受试者中有26%患有微量或大量白蛋白尿，糖耐量受损的受试者中这一比例增至43%，新诊断糖尿病受试者中为63%，既往诊断糖尿病受试者中为75%。对总人口（n = 1184）和仅糖尿病亚组（n = 318）评估了尿白蛋白浓度升高与假定危险因素之间的关联。空腹血糖和高血压是整个人群中最重要的独立相关因素，而血肌酐在糖尿病受试者中也很重要。未发现糖尿病发病年龄和病程与白蛋白浓度升高有显著关联。在糖耐量正常的受试者中，高血压和高尿酸血症是最重要的相关因素。这些结果表明，血糖、血压，可能还有肥胖和血尿酸是该人群中微量和大量白蛋白尿的重要可改变危险因素。
