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昆士兰远北地区原住民成年人中的蛋白尿及其相关生物医学因素:一项7年随访研究。

Albuminuria and its associated biomedical factors among indigenous adults in Far North Queensland: a 7-year follow up study.

作者信息

Li Ming, McDermott Robyn

机构信息

Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide, SA, 5001, Australia.

Faculty of Medicine, Health & Molecular Sciences, James Cook University, Cairns, QLD, 4870, Australia.

出版信息

BMC Nephrol. 2015 Dec 10;16:208. doi: 10.1186/s12882-015-0200-8.

Abstract

BACKGROUND

To document albuminuria prevalence and its associated factors in Aboriginal and Torres Strait Islander (TSI) adults with high renal and metabolic risks from 19 rural and remote north Queensland communities.

METHODS

One thousand nine hundred seventy-one indigenous adults were enrolled in 1998 and 566 completed follow up in 2007 in this population-based study. Measurements included weight, waist circumference (WC), blood pressure (BP), fasting glucose, lipids, gamma-glutamyltransferase (GGT), urinary albumin creatinine ratio (UACR), smoking, alcohol intake and physical activity (PA). Albuminuria was defined as an UACR > =2.5 g/mol in males and > =3.5 g/mol in females. The association between albuminuria and biomedical factors was assessed with generalised linear modelling.

RESULTS

Baseline albuminuria prevalence was 19.7 % (95 % CI: 18.0-21.6 %). Follow up prevalence was 42.4 % (95 % CI: 38.4-46.5 %) among the 566 adults having the 2(nd) UACR measurements. Follow-up albuminuria was associated with fasting glucose of 5.4 mmol/L (OR 2.5, 95 % CI 1.5-4.2), GGT tertiles in a dose-response manner (OR 2.0 for 2(nd) and 3.7 for 3(rd) tertile, p for trend <0.001), and abdominal overweight and obesity (OR 2.1, 95 % CI 1.1-3.9 and 5.4, 95 % CI: 2.2-13.5 respectively). Aboriginal people with diabetes were three times more likely of having albuminuria compared to TSI counterparts, while TSI smokers had twice the likelihood (95 % CI 1.2-3.2). At both baseline and follow up, albuminuria was more prevalent among older participants.

CONCLUSIONS

Indigenous Australians in north Queensland are at high risk of albuminuria. Overweight and obesity, glycaemia, increased GGT, and smoking were associated with albuminuria at baseline and/or follow up.

摘要

背景

记录来自昆士兰北部19个农村和偏远社区的具有高肾脏和代谢风险的原住民及托雷斯海峡岛民(TSI)成年人中蛋白尿的患病率及其相关因素。

方法

在这项基于人群的研究中,1998年招募了1971名原住民成年人,2007年有566人完成随访。测量指标包括体重、腰围(WC)、血压(BP)、空腹血糖、血脂、γ-谷氨酰转移酶(GGT)、尿白蛋白肌酐比值(UACR)、吸烟、饮酒和身体活动(PA)。蛋白尿定义为男性UACR≥2.5g/mol,女性UACR≥3.5g/mol。采用广义线性模型评估蛋白尿与生物医学因素之间的关联。

结果

基线蛋白尿患病率为19.7%(95%CI:18.0 - 21.6%)。在进行第二次UACR测量的566名成年人中,随访患病率为42.4%(95%CI:38.4 - 46.5%)。随访期蛋白尿与空腹血糖5.4mmol/L相关(OR 2.5,95%CI 1.5 - 4.2),与GGT三分位数呈剂量反应关系(第二三分位数OR 2.0,第三三分位数OR 3.7,趋势p<0.001),以及腹部超重和肥胖相关(分别为OR 2.1,95%CI 1.1 - 3.9和OR 5.4,95%CI:2.2 - 13.5)。患有糖尿病的原住民出现蛋白尿的可能性是TSI人群的三倍,而TSI吸烟者出现蛋白尿的可能性是其两倍(95%CI 1.2 - 3.2)。在基线和随访时,蛋白尿在老年参与者中更为普遍。

结论

昆士兰北部的澳大利亚原住民有较高的蛋白尿风险。超重和肥胖、血糖、GGT升高以及吸烟在基线和/或随访时与蛋白尿相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/313d/4676181/d06fd56372b4/12882_2015_200_Fig1_HTML.jpg

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