Department of Endocrinology, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China.
Medicine (Baltimore). 2023 Mar 17;102(11):e32911. doi: 10.1097/MD.0000000000032911.
Diabetes is a chronic disease and has huge pressure on patients and the medical system, especially for patients with diabetic complications, for example, diabetic nephropathy. Diabetic nephropathy is a diabetic complication associated with damage to the kidney. To improve the quality of life of patients with diabetes, it is necessary to understand the factors that are associated with diabetic nephropathy. The objective of the study was to find the prevalence of diabetic nephropathy in newly diagnosed patients with diabetes and to develop the association between clinicopathological parameters and diabetic nephropathy. In a case-control study, demographics, anthropometric, and clinicopathological parameters of a total of 305 newly diagnosed patients with diabetes (the fasting blood glucose ≥ 7.0 mM/L and/or glycosylated hemoglobin ≥ 6.5 mM/L) in Hebei province were included in the analysis. If the urine albumin to creatinine ratio was ≥ 30 (microalbuminuria) then patients were considered diabetic nephropathy. Among enrolled patients, 206 (68%) were males and 99 (32%) were females and they were 46 to 71 years old. Demographic variables and health-related behaviors were the same among patients with diabetes either with nephropathy (case group, n = 135) or patients without nephropathy (control group, n = 170, P > .05 for all). The prevalence of diabetic nephropathy was 44%. Female to male ratio was 1:1.7 in the case group. Patients with diabetic nephropathy had higher body weight (P < .0001), waist circumference (P = .0006), and body mass index (P = .0002) than those of patients without nephropathy. Abnormal urinary globulin (P = .041, odd ratio (OR): 1.1231) was associated with diabetic nephropathy. Aspartate transaminase (P = .0651, OR: 0.8541), alkaline phosphatase (P = .0661, OR: 0.8122), hypertension (P = .0821, OR: 0.8214), and blood urea nitrogen (P = .0842, OR: 0.9411) were not significantly associated with diabetic neuropathy. However, they are near the statistical cutoff value. The prevalence of diabetic nephropathy in newly diagnosed diabetic patients of Hebei province is higher than those of the other provinces. Urinary globulin excretion had a weak association with the presence of nephropathy defined by urinary albumin excretion in patients with diabetes. The presence of other diabetic complications is also an essential parameter for diabetic nephropathy. Males are more susceptible to diabetic nephropathy than females if diabetic (Evidence Level: V; Technical Efficacy: Stage 3).
糖尿病是一种慢性疾病,给患者和医疗系统带来了巨大的压力,尤其是对于患有糖尿病并发症的患者,例如糖尿病肾病。糖尿病肾病是一种与肾脏损伤有关的糖尿病并发症。为了提高糖尿病患者的生活质量,了解与糖尿病肾病相关的因素是必要的。本研究的目的是确定新诊断的糖尿病患者中糖尿病肾病的患病率,并探讨临床病理参数与糖尿病肾病之间的关系。在一项病例对照研究中,共纳入了河北省 305 名新诊断的糖尿病患者(空腹血糖≥7.0mmol/L 和/或糖化血红蛋白≥6.5mmol/L)的人口统计学、人体测量学和临床病理参数。如果尿白蛋白与肌酐的比值≥30(微量白蛋白尿),则认为患者患有糖尿病肾病。在纳入的患者中,206 名(68%)为男性,99 名(32%)为女性,年龄在 46 至 71 岁之间。无论患者是否患有肾病(病例组,n=135),他们的人口统计学变量和健康相关行为均相同(对照组,n=170,所有 P>.05)。糖尿病肾病的患病率为 44%。病例组中女性与男性的比例为 1:1.7。与无肾病的患者相比,患有糖尿病肾病的患者体重(P<0.0001)、腰围(P=0.0006)和体重指数(P=0.0002)更高。尿球蛋白异常(P=0.041,比值比(OR):1.1231)与糖尿病肾病有关。天门冬氨酸转氨酶(P=0.0651,OR:0.8541)、碱性磷酸酶(P=0.0661,OR:0.8122)、高血压(P=0.0821,OR:0.8214)和血尿素氮(P=0.0842,OR:0.9411)与糖尿病神经病变无显著相关性,但接近统计学截断值。河北省新诊断的糖尿病患者中糖尿病肾病的患病率高于其他省份。尿球蛋白排泄与糖尿病患者尿液白蛋白排泄定义的肾病存在有弱相关性。其他糖尿病并发症的存在也是糖尿病肾病的一个重要参数。如果患有糖尿病,男性比女性更容易患糖尿病肾病(证据水平:V;技术功效:第 3 级)。