Jang Miae, Oh Sohee, Noh Hye-Mi, Chun Sunyoung, Oh Hye Young, Park Kyung Hee, Paek Yu Jin, Song Hong Ji
Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Korean J Fam Med. 2015 Nov;36(6):316-22. doi: 10.4082/kjfm.2015.36.6.316. Epub 2015 Nov 20.
This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM).
We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables.
The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR.
The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.
本研究根据性别以及高血压(HTN)和糖尿病(DM)的合并症,探讨了与蛋白尿相关因素的差异。
我们纳入了来自韩国第五次全国健康与营养检查调查的3859名年龄在20至79岁之间的参与者(55%为女性)。如果参与者正在服用抗高血压或抗糖尿病药物、患有慢性肾衰竭、患有恶性肿瘤、在健康检查期间怀孕或处于经期,或者尿白蛋白数据缺失,则将其排除。蛋白尿由参与者的尿白蛋白-肌酐比值(uACR)定义。使用Pearson相关检验和简单线性回归分析自变量与因变量之间的关系。由于可能存在多重共线性,因此使用多元线性回归分析来确定在对其他潜在混杂自变量进行调整后,感兴趣的自变量与因变量之间的关联是否仍然显著。
与uACR显著相关的变量在性别之间以及患有HTN或DM合并症的受试者之间存在差异。在多元线性回归模型中,糖化血红蛋白A1c(P = 0.01)与无HTN和DM的男性的uACR呈正相关。在患有HTN或DM的男性中,收缩压和空腹血糖(P < 0.01)与uACR呈正相关。在患有HTN或DM的女性中,腰围(P = 0.011)和γ-谷氨酰转肽酶(P < 0.001)与uACR呈正相关(P < 0.05),而血糖水平(P = 0.019)与uACR呈负相关。
该研究表明,根据HTN和DM等合并症,与蛋白尿相关的因素在男性和女性中有所不同。