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秘鲁成年 2 型糖尿病患者血糖控制与蛋白尿的相关性:一项横断面分析研究。

Association between glycemic control and albuminuria among Peruvian adults with diabetes mellitus 2: a cross-sectional analytical study.

机构信息

Undergraduate Student, Faculty of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.

MD, MHEd. Researcher, Universidad Privada San Juan Bautista (UPSJB), Lima, Peru; and Assistant Manager, EsSalud, Instituto de Evaluación de Tecnologías en Salud e Investigación, Lima, Peru.

出版信息

Sao Paulo Med J. 2022 Nov-Dec;140(6):767-774. doi: 10.1590/1516-3180.2021.0448.R2.07022022.

Abstract

BACKGROUND

Albuminuria is a risk factor for microvascular and macrovascular complications in the diabetic population. However, few studies have correlated poor glycemic control and albuminuria prevalence in Hispanic populations.

OBJECTIVE

To evaluate the association between glycemic control and albuminuria among Peruvian adults with type 2 diabetes mellitus (T2DM).

DESIGN AND SETTING

Cross-sectional analytical study among adults with T2DM in Lima, Peru.

METHODS

We included adults over 18 years old who were in a clinical follow-up program at a private clinic in Lima in 2018. Poor glycemic control was defined as a serum value of glycosylated hemoglobin A1C (HbA1C) ≥ 7%. Albuminuria was defined as albumin values > 30 mg/dl in the first morning urine. We generated generalized linear regression models from the Poisson family with robust variance. We calculated the crude and adjusted prevalence ratios (PRs) with their 95% confidence interval (CI).

RESULTS

We analyzed 907 participants of median age 58 years (interquartile range, IQR 49 to 66), and 62.8% were males. The prevalence of poor glycemic control was 39.8%, and the prevalence of albuminuria was 22.7%. The prevalences of albuminuria in groups with poor glycemic control and adequate glycemic control were 32.7% and 16.1%, respectively. In the adjusted regression analysis, we found a statistically significant association between poor glycemic control and albuminuria (annual percentage rate, aPR = 1.70; 95% CI: 1.28-2.27).

CONCLUSIONS

The prevalence of poor glycemic control and albuminuria was high in our study population. Moreover, Peruvian T2DM adults with poor glycemic control were more likely to have albuminuria.

摘要

背景

白蛋白尿是糖尿病患者微血管和大血管并发症的一个风险因素。然而,很少有研究将血糖控制不佳与西班牙裔人群的白蛋白尿患病率相关联。

目的

评估秘鲁成年 2 型糖尿病(T2DM)患者血糖控制与白蛋白尿之间的关系。

设计和设置

在秘鲁利马的成人 2 型糖尿病患者中进行的横断面分析研究。

方法

我们纳入了 2018 年在利马一家私人诊所进行临床随访的年龄在 18 岁以上的成年 T2DM 患者。血糖控制不佳定义为糖化血红蛋白 A1C(HbA1C)血清值≥7%。白蛋白尿定义为晨尿中白蛋白值>30mg/dl。我们从泊松家族生成了具有稳健方差的广义线性回归模型。我们计算了未经调整和调整后的患病率比(PR)及其 95%置信区间(CI)。

结果

我们分析了 907 名中位年龄为 58 岁(四分位间距,IQR 49 至 66)的参与者,其中 62.8%为男性。血糖控制不佳的患病率为 39.8%,白蛋白尿的患病率为 22.7%。血糖控制不佳和血糖控制良好组的白蛋白尿患病率分别为 32.7%和 16.1%。在调整后的回归分析中,我们发现血糖控制不佳与白蛋白尿之间存在统计学显著关联(年增长率,aPR=1.70;95%CI:1.28-2.27)。

结论

我们的研究人群中血糖控制不佳和白蛋白尿的患病率都很高。此外,血糖控制不佳的秘鲁 T2DM 成年人更有可能出现白蛋白尿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad98/9671563/31de52fc0f42/1806-9460-1516-3180-2021-0448-R2-07022022-gf1.jpg

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