Sana Muhammad Ahsan, Chaudhry Manahil, Malik Ayesha, Iqbal Noreena, Zakiuddin Ayesha, Abdullah Mohammad
Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK.
Medicine, Hameed Latif Hospital, Lahore, PAK.
Cureus. 2020 Dec 27;12(12):e12318. doi: 10.7759/cureus.12318.
The presence of albumin in the urine is a marker of glomerular involvement in type 2 diabetes mellitus (T2DM), depicting diabetic nephropathy. Strict glycemic control can prevent and delay the occurrence of microalbuminuria and other diabetic complications. Therefore, we conducted a study to report the prevalence of microalbuminuria in type 2 diabetics along with its association with diabetic control.
A total of 133 patients with T2DM were consecutively included and their co-morbidities, body mass index, mode of treatment of diabetes (oral hypoglycemic drugs and/or insulin), duration since diagnosis of T2DM, and hemoglobin A1c (HbA1c) levels were recorded. A morning, mid-stream urine sample was collected and a urine spot for albumin:creatinine ratio (UACR) was assessed. Descriptive and analytic statistics were drawn with different variables and UACR values.
The mean age of the participants was 54.5 ± 10.3 years which included 60.9% males and 39.1% females. The overall incidence of diabetic nephropathy was 30.1%, with 25.6% having microalbuminuria and 4.5% having macroalbuminuria. Pearson correlation test was used to compare UACR and duration of diabetes (p=0.034) and HbA1c (p=0.001).
UACR was higher in patients with uncontrolled T2DM (in terms of higher HbA1c value) and with a longer duration since diagnosis. We recommend that UACR should be inculcated in routine practice, annually, for all patients with T2DM for gauging the development of underlying renal involvement and prompt management.
尿中白蛋白的存在是2型糖尿病(T2DM)肾小球受累的标志物,提示糖尿病肾病。严格的血糖控制可预防和延缓微量白蛋白尿及其他糖尿病并发症的发生。因此,我们开展了一项研究,以报告2型糖尿病患者微量白蛋白尿的患病率及其与糖尿病控制情况的关联。
连续纳入133例T2DM患者,记录他们的合并症、体重指数、糖尿病治疗方式(口服降糖药和/或胰岛素)、T2DM诊断后的病程以及糖化血红蛋白(HbA1c)水平。收集晨尿中段尿样本,评估尿白蛋白与肌酐比值(UACR)。对不同变量和UACR值进行描述性和分析性统计。
参与者的平均年龄为54.5±10.3岁,其中男性占60.9%,女性占39.1%。糖尿病肾病的总体发生率为30.1%,其中微量白蛋白尿患者占25.6%,大量白蛋白尿患者占4.5%。采用Pearson相关检验比较UACR与糖尿病病程(p=0.034)以及HbA1c(p=0.001)。
在未得到控制的T2DM患者中(根据较高的HbA1c值判断)以及诊断后病程较长的患者中,UACR较高。我们建议,应将UACR纳入所有T2DM患者的常规年度检查中,以评估潜在肾脏受累情况的发展并及时进行处理。