Afifa Koubaa, Belguith Asma Sriha, Nabil Harzallah, Ahlem Bellaleh, Mounira Sahtout, Kawthar Younes, Sonia Triki, Ilhem Hellara, Fadoua Neffati, Fadhel Najjar, Mohamed Soltani
Stah Jabeur Primary Health Center, Monastir Health Group, 5000 Monastir, Tunisia.
Department of Preventive Medicine and Epidemiology, Faculty of Medicine, Monastir, Tunisia.
Int J Chronic Dis. 2016;2016:2910627. doi: 10.1155/2016/2910627. Epub 2016 May 18.
Background. Using Micral-test (MT) for screening microalbuminuria (MA) among type 2 diabetics (T2D) is helpful. We aimed at determining prevalence of MA and at describing the MT validity. Methods. We studied 182 T2D followed up in family medicine. Two 24-hour urinary quantitative assays of MA had been used as a gold standard. Results. Prevalence of MA was 23%, CI 95%: 16.9-29.1. MT validity was 77% for sensitivity, 88% for negative predictive value, and 0.2 for Kappa coefficient (p = 0.001). Among subjects having a blood pressure ≥130/80 mmHg, having a CHT/HDL ratio ≥ 3, being a T2D for more than 5 years, and being women, negative predictive values were, respectively, 91%, 89%, 95%, and 91%. The area under the ROC curve was 0.81 in men (p = 0.008) and 0.80 when diabetes duration exceeds 5 years (p = 0.001). The MA value at 100% Sp for MT was 35 mg/L. Conclusion. The use of MT in primary healthcare for yearly screening for MA in T2D must be accentuated especially when diabetes duration exceeds 5 years or when associated with other cardiovascular risks.
背景。使用微量白蛋白尿检测（MT）对2型糖尿病患者（T2D）进行微量白蛋白尿（MA）筛查很有帮助。我们旨在确定MA的患病率并描述MT的有效性。方法。我们研究了182例在家庭医学中接受随访的T2D患者。两项24小时尿MA定量检测被用作金标准。结果。MA的患病率为23%，95%置信区间：16.9 - 29.1。MT的敏感性为77%，阴性预测值为88%，kappa系数为0.2（p = 0.001）。在血压≥130/80 mmHg、CHT/HDL比值≥3、患T2D超过5年以及为女性的受试者中，阴性预测值分别为91%、89%、95%和91%。男性的ROC曲线下面积为0.81（p = 0.008），糖尿病病程超过5年时为0.80（p = 0.001）。MT在100%特异度时的MA值为35 mg/L。结论。在基层医疗中，必须加强使用MT对T2D患者进行MA的年度筛查，尤其是当糖尿病病程超过5年或伴有其他心血管风险时。
