Lee K U, Park J Y, Kim S W, Lee M H, Kim G S, Park S K, Park J S
Department of Medicine, College of Medicine, University of Ulsan, Seoul, Korea.
Diabetes Care. 1995 Jun;18(6):793-9. doi: 10.2337/diacare.18.6.793.
To determine the prevalence and the associated features of microalbuminuria and overt proteinuria in Korean subjects with non-insulin-dependent diabetes mellitus (NIDDM) attending a hospital clinic.
A total of 631 Korean outpatients with NIDDM were studied cross-sectionally for the presence of albuminuria and other micro- and macrovascular complications. Urinary albumin excretion rate (AER) was determined in timed overnight urine samples. Subjects were divided into three groups: no nephropathy (AER < 20 micrograms/min), microalbuminuria (AER 20-200 micrograms/min), and overt proteinuria (AER > 200 micrograms/min).
Increased AER was present in 34% of our patients: 20% had microalbuminuria and 14% had overt proteinuria. Of patients with diabetes duration > or = 15 years, 35% had overt proteinuria. Most (82%) patients with overt proteinuria had retinopathy. Although the prevalence of microalbuminuria as a whole did not differ according to diabetes duration, the prevalence of microalbuminuria in the patients with retinopathy increased with diabetes duration. The microalbuminuric patients without retinopathy (diabetes duration < 5 years) were characterized by higher prevalence of hypertension and previous obesity, higher plasma triglyceride level, and lower plasma high-density lipoprotein cholesterol level.
The prevalence of overt proteinuria in Korean NIDDM patients with a long diabetes duration was higher than that reported in Caucasians. Our data also suggest that the clinical meaning of microalbuminuria may be different based on the presence or the absence of retinopathy. Microalbuminuria in patients with retinopathy most probably would reflect diabetic nephropathy. In contrast, some recent-onset NIDDM patients with microalbuminuria in the absence of retinopathy had features of syndrome X.
确定在医院门诊就诊的韩国非胰岛素依赖型糖尿病（NIDDM）患者中微量白蛋白尿和显性蛋白尿的患病率及相关特征。
对631例韩国NIDDM门诊患者进行横断面研究，以检测蛋白尿及其他微血管和大血管并发症的存在情况。通过定时过夜尿样测定尿白蛋白排泄率（AER）。受试者分为三组：无肾病（AER<20微克/分钟）、微量白蛋白尿（AER 20 - 200微克/分钟）和显性蛋白尿（AER>200微克/分钟）。
34%的患者AER升高：20%有微量白蛋白尿，14%有显性蛋白尿。糖尿病病程≥15年的患者中，35%有显性蛋白尿。大多数（82%）显性蛋白尿患者有视网膜病变。虽然总体微量白蛋白尿患病率不因糖尿病病程而异，但视网膜病变患者中微量白蛋白尿患病率随糖尿病病程增加。无视网膜病变的微量白蛋白尿患者（糖尿病病程<5年）的特点是高血压和既往肥胖患病率较高、血浆甘油三酯水平较高以及血浆高密度脂蛋白胆固醇水平较低。
韩国病程较长的NIDDM患者中显性蛋白尿的患病率高于白种人报道的患病率。我们的数据还表明，微量白蛋白尿的临床意义可能因有无视网膜病变而不同。有视网膜病变患者的微量白蛋白尿很可能反映糖尿病肾病。相反，一些近期发病、无视网膜病变的NIDDM微量白蛋白尿患者具有X综合征的特征。
