Nah Eun Hee, Cho Seon, Kim Suyoung, Cho Han Ik
Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea.
Ann Lab Med. 2017 Jan;37(1):28-33. doi: 10.3343/alm.2017.37.1.28.
Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes.
Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests.
The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of <30, 30-300, and >300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method.
The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.
蛋白尿通常被认为是肾脏和心血管功能障碍的敏感标志物。它可用于帮助预测糖尿病患者肾病和心血管疾病的发生。糖尿病前期个体有发生大血管和微血管病变的倾向，从而导致视网膜病变、心血管疾病和慢性肾病风险增加。我们评估了试纸条法检测糖尿病前期和糖尿病患者尿白蛋白肌酐比值（ACR）的临床价值。
在定期健康检查期间，从226例糖尿病前期患者和275例糖尿病患者中获取随机尿样。使用试纸条法和实验室定量检测法测量尿ACR。
糖尿病前期和糖尿病患者中，采用ACR试纸条法检测蛋白尿的阳性率分别为15.5%（微量白蛋白尿，14.6%；大量白蛋白尿，0.9%）和30.5%（微量白蛋白尿，25.1%；大量白蛋白尿，5.5%）。在糖尿病前期人群中，ACR试纸条法的灵敏度、特异度、阳性预测值、阴性预测值和总准确率分别为92.0%、94.0%、65.7%、99.0%和93.8%；糖尿病患者中的相应值分别为80.0%、91.6%、81.0%、91.1%和88.0%。采用实验室检测法时，试纸条检测中ACR测量范围<30、30 - 300和>300 mg/g的中位数[四分位间距]分别为9.4 [6.3 - 15.4]、46.9 [26.5 - 87.7]和368.8 [296.2 - 575.2] mg/g。
ACR试纸条检测显示出高灵敏度、特异度和阴性预测值，表明该检测可用于糖尿病前期和糖尿病患者蛋白尿的筛查。
