Schmitz A, Vaeth M
Second University Clinic of Internal Medicine, Kommunehospitalet, Aarhus, Denmark.
Diabet Med. 1988 Mar;5(2):126-34. doi: 10.1111/j.1464-5491.1988.tb00958.x.
The impact of microalbuminuria on mortality as well as other risk factors was investigated in a 10-year follow-up study of 503 predominantly non-insulin-dependent diabetic patients of whom 265 had died. Using Cox's regression analysis the prognostic influence of age, sex, age at diagnosis, known diabetes duration, blood pressure, fasting plasma glucose, relative weight, serum creatinine, retinopathy, and treatment was evaluated as well as morning urine albumin concentration (UAC) in four categories, i.e. UAC less than or equal to 15 micrograms/ml (normal), 15 micrograms/ml less than UAC less than or equal to 40 micrograms/ml, 40 micrograms/ml less than UAC less than or equal to 200 micrograms/ml and UAC greater than 200 micrograms/ml. Age, UAC, known duration, and serum creatinine were the only significant risk factors. After correction for the other three independent risk factors, the hazard ratios in the elevated UAC categories relative to the group with UAC less than or equal to 15 micrograms/ml were 1.53 (p = 0.007), 2.28 (p = 0.000002), and 1.82 (p = 0.02). The statistically significant correlations with UAC were: age (r = 0.09, p less than 0.05), duration (r = 0.14, p less than 0.01), systolic blood pressure (r = 0.12, p less than 0.01), serum creatinine (r = 0.33, p less than 0.001), and fasting plasma glucose (r = 0.12, p less than 0.01). Increased UAC was associated also with retinopathy (p = 0.01). Fifty-eight per cent of the deaths were caused by cardiovascular disease or stroke; only 3% died from uraemia. A reinvestigation including blood pressure, fasting plasma glucose, and UAC was made on 208 survivors.
在一项对503名主要为非胰岛素依赖型糖尿病患者的10年随访研究中，调查了微量白蛋白尿对死亡率以及其他风险因素的影响，其中265人已经死亡。使用Cox回归分析评估了年龄、性别、诊断时年龄、已知糖尿病病程、血压、空腹血糖、相对体重、血清肌酐、视网膜病变和治疗的预后影响，以及晨尿白蛋白浓度（UAC）的四个类别，即UAC小于或等于15微克/毫升（正常）、15微克/毫升＜UAC≤40微克/毫升、40微克/毫升＜UAC≤200微克/毫升和UAC＞200微克/毫升。年龄、UAC、已知病程和血清肌酐是仅有的显著风险因素。在校正其他三个独立风险因素后，UAC升高类别相对于UAC小于或等于15微克/毫升组的风险比分别为1.53（p = 0.007）、2.28（p = 0.000002）和1.82（p = 0.02）。与UAC具有统计学显著相关性的因素有：年龄（r = 0.09，p＜0.05）、病程（r = 0.14，p＜0.01）、收缩压（r = 0.12，p＜0.01）、血清肌酐（r = 0.33，p＜0.001）和空腹血糖（r = 0.12，p＜0.01）。UAC升高还与视网膜病变相关（p = 0.01）。58%的死亡由心血管疾病或中风引起；仅3%死于尿毒症。对208名幸存者进行了包括血压、空腹血糖和UAC在内的再次调查。
