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60岁以上长期使用二甲双胍的2型糖尿病患者尿白蛋白/肌酐比值升高的危险因素。

Risk factors for elevated urinary albumin/creatinine ratio in type 2 diabetes mellitus patients over 60 years old with long-term metformin use.

作者信息

Wang Shaofeng, Xu Bin, Zhang Haiying, Dai Haojun, Gong Jie, He Ying, Shi Jinjin, Ling Jingwen, Hashim Rosnani, Wei Yihong

机构信息

General Department, Huanglou Community Health Centre of Shanghai, Shanghai, China.

Faculty of Pharmacy, University of Cyberjaya, Cyberjaya, Selangor, Malaysia.

出版信息

Medicine (Baltimore). 2025 Jun 27;104(26):e42982. doi: 10.1097/MD.0000000000042982.

Abstract

Patients with type 2 diabetes mellitus (T2DM) suffered renal disease with the increase of duration and age. This study aimed to analyze the risk factors for elevated urinary albumin/creatinine ratio (UACR) in T2DM patients over 60 years old with long-term metformin use. Subjects were recruited from Huanglou Community Health Centre of Shanghai from June to December 2022. A total of 466 subjects were included and divided into 2 groups according to 30 mg/g of UACR. Four hundred sixty-six T2DM patients were enrolled in this study, with UACR elevated group (n = 106) and UACR normal group (n = 360). Linear regression showed significant relation between age and UACR elevating. A correlation between urine glucose and urine protein levels was also found. The univariate logistic regression analysis showed that age, smoking, drinking, urine glucose, fatty liver, and homocysteine were related to elevated UACR (all P < .05). The multivariate logistic regression analysis showed that age, drinking, urine glucose, and fatty liver were independently related to elevated UACR elevating (all P < .05). For T2DM over 60 years old patients with long-term metformin use, aging, drinking, urine glucose, and fatty liver were independent risk factors for UACR elevating, which implied those patients should take intervention in advance.

摘要

2型糖尿病(T2DM)患者会随着病程延长和年龄增长而出现肾脏疾病。本研究旨在分析长期使用二甲双胍的60岁以上T2DM患者尿白蛋白/肌酐比值(UACR)升高的危险因素。研究对象于2022年6月至12月从上海黄楼社区卫生服务中心招募。共纳入466名受试者,并根据UACR 30 mg/g分为2组。本研究共纳入466例T2DM患者,分为UACR升高组(n = 106)和UACR正常组(n = 360)。线性回归显示年龄与UACR升高之间存在显著关联。还发现尿糖与尿蛋白水平之间存在相关性。单因素logistic回归分析显示,年龄、吸烟、饮酒、尿糖、脂肪肝和同型半胱氨酸与UACR升高有关(均P < 0.05)。多因素logistic回归分析显示,年龄、饮酒、尿糖和脂肪肝与UACR升高独立相关(均P < 0.05)。对于长期使用二甲双胍的60岁以上T2DM患者,年龄、饮酒、尿糖和脂肪肝是UACR升高的独立危险因素,这意味着这些患者应提前进行干预。

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