Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Pathology and Diagnostics, Kampala International University Teaching Hospital, Bushenyi, Uganda.
J Diabetes Res. 2019 Dec 16;2019:3534260. doi: 10.1155/2019/3534260. eCollection 2019.
Diabetic nephropathy (DN) is a common finding in diabetic patients. Microalbuminuria is the earliest clinical evidence of DN. Early detection of microalbuminuria is very important; it allows timely interventions to prevent progression to macroalbuminuria and later end-stage renal disease (ESRD).
To determine the prevalence of microalbuminuria in diabetic patients and establish its association with traditional serum renal markers in assessment of incipient nephropathy.
This cross-sectional study involved 140 participants with diabetes mellitus (DM) attending the diabetic clinic of Mbarara Regional Referral Hospital. Questionnaires were used to obtain participant data after obtaining written informed consent. Data collected included: age, sex, level of education, history of smoking and alcohol consumption, hypertension, body mass index, family history, and duration of DM. Morning spot urine samples were collected from each participant and blood drawn for analysis of other renal markers. Urine microalbumin was determined quantitatively using immunoturbidity assay (Microalbumin kit, Mindray). Serum creatinine and uric acid and glucose levels were determined by spectrophotometric methods.
The overall prevalence of microalbuminuria was 22.9%. Using a simple and multiple linear regression model, serum creatinine ( = 0.010, 95% CI (0.005, 0.014), = 0.0001) and glucose ( = 0.030, 95% CI (0.011, 0.048), = 0.0017) levels were significantly associated with microalbuminuria. After adjusting for linearity, family history of DM was the only predictor of microalbuminuria ( = 0.275, 95% CI (0.043, 0.508), = 0.002). Although microalbuminuria was weakly associated with eGFR (OR = 1.2, 95% CI (0.24, 5.96)), the relationship was not statistically significant ( = 0.824).
The prevalence of microalbuminuria in patients with diabetes in this study was high. The study suggests the need to screen for microalbuminuria early to reduce the possible burden of ESRD. When serum creatinine is used as a renal function marker among diabetic patients, it should be combined with microalbuminuria for better assessment of incipient nephropathy.
糖尿病肾病（DN）是糖尿病患者的常见病症。微量白蛋白尿是 DN 的最早临床证据。早期发现微量白蛋白尿非常重要；它可以及时进行干预，防止进展为大量白蛋白尿和随后的终末期肾病（ESRD）。
确定糖尿病患者微量白蛋白尿的患病率，并确定其与传统血清肾标志物在评估早期肾病中的相关性。
这是一项横断面研究，涉及在姆巴拉拉地区转诊医院糖尿病诊所就诊的 140 名糖尿病患者。在获得书面知情同意后，使用问卷获取参与者数据。收集的数据包括：年龄、性别、教育水平、吸烟和饮酒史、高血压、体重指数、家族史和糖尿病病程。从每位参与者采集晨尿样本，并采集血液进行其他肾脏标志物分析。使用免疫比浊法（微量白蛋白试剂盒，迈瑞）定量测定尿微量白蛋白。血清肌酐、尿酸和血糖水平通过分光光度法测定。
微量白蛋白尿的总患病率为 22.9%。使用简单和多元线性回归模型，血清肌酐（=0.010，95%置信区间（0.005，0.014），=0.0001）和血糖（=0.030，95%置信区间（0.011，0.048），=0.0017）水平与微量白蛋白尿显著相关。在调整线性后，糖尿病家族史是微量白蛋白尿的唯一预测因子（=0.275，95%置信区间（0.043，0.508），=0.002）。尽管微量白蛋白尿与 eGFR 呈弱相关（OR=1.2，95%置信区间（0.24，5.96）），但无统计学意义（=0.824）。
本研究中糖尿病患者微量白蛋白尿的患病率较高。该研究表明，需要早期筛查微量白蛋白尿，以降低 ESRD 的可能负担。当血清肌酐被用作糖尿病患者的肾功能标志物时，应结合微量白蛋白尿进行更好的早期肾病评估。
