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乌干达新诊断糖尿病患者中白蛋白与肌酐比值在筛查微量白蛋白尿中的效用:一项横断面研究

Utility of albumin to creatinine ratio in screening for microalbuminuria among newly diagnosed diabetic patients in Uganda: a cross sectional study.

作者信息

Muddu Martin, Mutebi Edrisa, Ssinabulya Isaac, Kizito Samuel, Mulindwa Frank, Kiiza Charles Mondo

机构信息

Department of Medicine Makerere University College of Health Sciences, Mulago Hospital Complex.

Clinical Epidemiology Unit, Makerere University College of Health Sciences.

出版信息

Afr Health Sci. 2019 Mar;19(1):1607-1616. doi: 10.4314/ahs.v19i1.36.

Abstract

BACKGROUND

The aim of this study was to determine the prevalence and factors associated with microalbuminuria among newly diagnosed diabetic patients in Mulago National Referral Hospital, Uganda.

METHODS

In this cross-sectional study conducted between June 2014 and January 2015, we collected information on patients' socio-demographics, biophysical profile, blood pressure, biochemical testing and echocardiographic findings using a pre-tested questionnaire. Bivariate and multivariate logistic regression analyses were used to investigate the association of several factors with microalbuminuria.

RESULTS

Of the 175 patients recruited, males were 90(51.4%) and the mean age was 46±15 years. Majority of patients had type 2 DM 140 (80.0%) and the rest had type 1 DM 35 (20.0%). Mean glycated hemoglobin (HbA1C) was 13.9±5.3%. Mean duration of diabetes was 2 months. Prevalence of microalbuminuria was 47.4 % (95% CI: 40.0%-54.9%) overall. Pregnancy was associated with microalbuminuria (OR7.74[95%CI.1.01-76.47] P=0.050) while mild and moderate physical activity at work were inversely associated with microalbuminuria respectively (OR0.08[95%CI0.01-0.95] P=0.046) and (OR0.07[95%CI0.01-0.77] P=0.030).

CONCLUSION

Prevalence of microalbuminuria was high in this group. Physical activity at work may be protective against microalbuminuria and this calls for longitudinal studies. Early detection and management of microalbuminuria in diabetics may slow progression to overt diabetic nephropathy (DN).

摘要

背景

本研究旨在确定乌干达穆拉戈国家转诊医院新诊断糖尿病患者中微量白蛋白尿的患病率及相关因素。

方法

在2014年6月至2015年1月进行的这项横断面研究中,我们使用预先测试的问卷收集了患者的社会人口统计学、生物物理特征、血压、生化检测和超声心动图检查结果等信息。采用双变量和多变量逻辑回归分析来研究多个因素与微量白蛋白尿的关联。

结果

在招募的175名患者中,男性90名(51.4%),平均年龄为46±15岁。大多数患者为2型糖尿病,共140例(80.0%),其余35例(20.0%)为1型糖尿病。糖化血红蛋白(HbA1C)平均值为13.9±5.3%。糖尿病平均病程为2个月。总体微量白蛋白尿患病率为47.4%(95%可信区间:40.0%-54.9%)。妊娠与微量白蛋白尿相关(比值比7.74[95%可信区间1.01-76.47],P=0.050),而工作时轻度和中度体力活动分别与微量白蛋白尿呈负相关(比值比0.08[95%可信区间0.01-0.95],P=0.046)和(比值比0.07[95%可信区间0.01-0.77],P=0.030)。

结论

该组微量白蛋白尿患病率较高。工作时的体力活动可能对微量白蛋白尿有保护作用,这需要进行纵向研究。糖尿病患者微量白蛋白尿的早期检测和管理可能会减缓向显性糖尿病肾病(DN)的进展。

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