日本糖尿病并发症及其预防前瞻性研究 5：日本糖尿病患者白蛋白尿和肾功能障碍的患病率及相关临床因素。
Prevalence of albuminuria and renal dysfunction, and related clinical factors in Japanese patients with diabetes: The Japan Diabetes Complication and its Prevention prospective study 5.
机构信息
The Japan Diabetes Society, Tokyo, Japan.
Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.
出版信息
J Diabetes Investig. 2020 Mar;11(2):325-332. doi: 10.1111/jdi.13116. Epub 2019 Sep 25.
AIMS/INTRODUCTION: To clarify the prevalence of albuminuria and renal dysfunction, and related factors in Japanese patients with diabetes, we analyzed the baseline data of the Japan Diabetes Complication and its Prevention prospective study.
MATERIALS AND METHODS
We used the data of 355 patients with type 1 diabetes and 5,194 patients with type 2 diabetes to evaluate the prevalence of albuminuria and renal dysfunction, and related factors. A binomial logistic regression analysis was used to investigate independent contributing factors for estimated glomerular filtration rate <60 mL/min/1.73 m or albuminuria.
RESULTS
The prevalence of microalbuminuria and macroalbuminuria was 15.2% (54/355) and 3.1% (11/355) in type 1 diabetes patients, and 25.0% (1,298/5,194) and 5.1% (265/5,194) in type 2 diabetes patients, respectively. The proportion of renal dysfunction (estimated glomerular filtration rate <60 mL/min/1.73 m ) was 9.9% (35/355) in type 1 diabetes patients, and 15.3% (797/5,194) in type 2 diabetes patients. The proportion of patients with renal dysfunction with normoalbuminuria was 7.3% (26/355) for type 1 diabetes patients, and 9.0% (467/5,194) for type 2 diabetes patients. The factors related to albuminuria in type 2 diabetes patients were glycated hemoglobin, hypertension, age, duration of diabetes, body mass index and estimated glomerular filtration rate. In contrast, factors to related renal dysfunction were age, duration of diabetes, dyslipidemia, hypertension, body mass index, male sex and albuminuria.
CONCLUSIONS
We showed the recent prevalence of albuminuria and renal dysfunction, and related factors in Japanese type 1 and type 2 diabetes patients using the baseline data of the Japan Diabetes Complication and its Prevention prospective study. The current results suggest that renal disease in patients with type 2 diabetes is heterogeneous, and different mechanisms might be involved in albuminuria and deterioration of renal function.
目的/引言：为了阐明日本糖尿病患者白蛋白尿和肾功能障碍的流行情况及其相关因素，我们对日本糖尿病并发症及其预防前瞻性研究的基线数据进行了分析。
材料和方法
我们使用了 355 例 1 型糖尿病患者和 5194 例 2 型糖尿病患者的数据，评估了白蛋白尿和肾功能障碍的流行情况及其相关因素。采用二项逻辑回归分析探讨了估计肾小球滤过率<60 mL/min/1.73 m 或白蛋白尿的独立影响因素。
结果
1 型糖尿病患者中微量白蛋白尿和大量白蛋白尿的患病率分别为 15.2%（54/355）和 3.1%（11/355），2 型糖尿病患者中分别为 25.0%（1298/5194）和 5.1%（265/5194）。肾功能障碍（估计肾小球滤过率<60 mL/min/1.73 m）的比例在 1 型糖尿病患者中为 9.9%（35/355），在 2 型糖尿病患者中为 15.3%（797/5194）。1 型糖尿病患者肾功能障碍伴正常白蛋白尿的比例为 7.3%（26/355），2 型糖尿病患者为 9.0%（467/5194）。2 型糖尿病患者白蛋白尿相关的因素有糖化血红蛋白、高血压、年龄、糖尿病病程、体重指数和估计肾小球滤过率。相比之下，与肾功能障碍相关的因素有年龄、糖尿病病程、血脂异常、高血压、体重指数、男性和白蛋白尿。
结论
我们利用日本糖尿病并发症及其预防前瞻性研究的基线数据，展示了日本 1 型和 2 型糖尿病患者近期的白蛋白尿和肾功能障碍流行情况及其相关因素。目前的结果表明，2 型糖尿病患者的肾脏疾病具有异质性，可能涉及不同的机制导致白蛋白尿和肾功能恶化。
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