Ramaphane Tshireletso, Gezmu Alemayehu M, Tefera Endale, Gabaitiri Lesego, Nchingane Seeletso, Matsheng-Samuel Motlalekgomo, Joel Dipesalema
Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Department of Statistics, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana.
Diabetes Metab Syndr Obes. 2021 Nov 2;14:4415-4422. doi: 10.2147/DMSO.S322847. eCollection 2021.
Microalbuminuria is considered the earliest sign of diabetic nephropathy among patients with type 1 diabetes mellitus (T1DM). The prevalence of microalbuminuria among African children with T1DM is reported to be high, yet its prevalence and population-specific risk factors in Botswana are not known.
This study aimed to determine the prevalence of microalbuminuria among children and young adults with T1DM in Botswana and identify factors associated with microalbuminuria in this population.
A retrospective cross-sectional study was conducted on 127 T1DM patients aged <24 years followed at a pediatric endocrinology clinic in Botswana from 2010 to 2017. Clinical, laboratory, and demographic data were collected using chart review and patient surveys. Descriptive statistics were reported as mean and standard deviation for continuous variables, and frequency and percentage for categorical variables. Prevalence of microalbuminuria was calculated as a simple proportion. Group comparison was done using two-sample independent -test, -test, or Fisher's exact test and logistic regression to assess for associations. Level of significance was set at p<0.05.
There were a total of 71 (55.9%) females. The mean age was 18.7 (±5) years and mean duration of T1DM was 6.6 (±4.6) years. Most study participants were of African descent. The prevalence of microalbuminuria was 28.3%. Group comparison revealed gender (p= 0.040), duration of diabetes (p= 0.002), systolic blood pressure (p=0.003), baseline glycated hemoglobin (HbA1c) (p=0.009) and Tanner's stage (p=008) to be significantly associated with microalbuminuria. On binary logistic regression, only gender (p=0.039) and baseline HbA1c (p=0.039) were independently associated with the presences of microalbuminuria.
This study identified a high prevalence of microalbuminuria among children and young adults with T1DM in Botswana and reaffirms the importance of early detection, glycemic control, and regular screening to prevent diabetic nephropathy.
微量白蛋白尿被认为是1型糖尿病（T1DM）患者糖尿病肾病的最早迹象。据报道，非洲T1DM儿童中微量白蛋白尿的患病率很高，但博茨瓦纳的患病率及其特定人群的危险因素尚不清楚。
本研究旨在确定博茨瓦纳T1DM儿童和青年中微量白蛋白尿的患病率，并确定该人群中与微量白蛋白尿相关的因素。
对2010年至2017年在博茨瓦纳一家儿科内分泌诊所随访的127名年龄小于24岁的T1DM患者进行了一项回顾性横断面研究。通过病历审查和患者调查收集临床、实验室和人口统计学数据。连续变量的描述性统计报告为均值和标准差，分类变量的描述性统计报告为频率和百分比。微量白蛋白尿的患病率按简单比例计算。采用两样本独立t检验、χ²检验或Fisher精确检验以及逻辑回归进行组间比较，以评估相关性。显著性水平设定为p<0.05。
共有71名（55.9%）女性。平均年龄为18.7（±5）岁，T1DM平均病程为6.6（±4.6）年。大多数研究参与者为非洲裔。微量白蛋白尿的患病率为28.3%。组间比较显示，性别（p=0.040）、糖尿病病程（p=0.002）、收缩压（p=0.003）、基线糖化血红蛋白（HbA1c）（p=0.009）和坦纳分期（p=0.008）与微量白蛋白尿显著相关。在二元逻辑回归中，只有性别（p=0.039）和基线HbA1c（p=0.039）与微量白蛋白尿的存在独立相关。
本研究发现博茨瓦纳T1DM儿童和青年中微量白蛋白尿的患病率很高，并重申了早期检测、血糖控制和定期筛查对预防糖尿病肾病的重要性。
