Alzaid A A, Sobki S, De Silva V
Department of Medicine, Armed Forces Hospital, Riyadh, Saudi Arabia.
Diabetes Res Clin Pract. 1994 Dec 16;26(2):115-20. doi: 10.1016/0168-8227(94)90148-1.
Prevalence of diabetic nephropathy varies in different racial groups, being especially high in communities that have abandoned an active traditional living and embraced a modern but sedentary life-style. As a new and rapidly developing country, Saudi Arabia has witnessed impressive changes in socio-economic growth and development and concurrently, a disturbing trend in non-insulin-dependent diabetes mellitus (NIDDM). These observations therefore prompted us to investigate the prevalence of microalbuminuria among Saudi Arabians with NIDDM. Two hundred and eleven patients attending a large Diabetic Clinic in Riyadh were screened for microalbuminuria (30-300 mg/24 h). Twenty-seven subjects had clinical proteinuria (dipstick-positive) and were excluded, leaving 184 cases for analysis. Seventy-six subjects (76/184, 41.3%) had microalbuminuria. These subjects had higher fasting plasma glucose concentrations (P = 0.002) and greater body mass index (P = 0.049) than subjects with normal albumin excretion rate (< 30 mg/24 h). There were no significant differences between subjects with and without microalbuminuria with regards to fasting total plasma cholesterol and triglycerides concentrations, frequency of hypertension, duration of diabetes or type of therapy for diabetes. In multivariate analysis, glycaemia (P < 0.005) and years since diagnosis of diabetes (P = 0.05) remained independently associated with albumin excretion rate. We conclude that microalbuminuria is exceedingly common in a clinic-based population of Saudi Arabians with NIDDM and its presence is closely related to glycaemic control. Whether the prevalence of microalbuminuria is truly increased in the diabetic population at large in Saudi Arabia must now await further population-based studies.
糖尿病肾病的患病率在不同种族群体中有所不同,在那些摒弃了积极的传统生活方式而接受现代但久坐不动生活方式的社区中尤其高。作为一个快速发展的新兴国家,沙特阿拉伯在社会经济增长和发展方面发生了令人瞩目的变化,与此同时,非胰岛素依赖型糖尿病(NIDDM)出现了令人不安的趋势。因此,这些观察结果促使我们调查沙特阿拉伯NIDDM患者中微量白蛋白尿的患病率。对利雅得一家大型糖尿病诊所的211名患者进行了微量白蛋白尿(30 - 300 mg/24 h)筛查。27名受试者有临床蛋白尿(试纸阳性)被排除,剩下184例进行分析。76名受试者(76/184,41.3%)有微量白蛋白尿。这些受试者的空腹血糖浓度(P = 0.002)和体重指数更高(P = 0.049),高于白蛋白排泄率正常(< 30 mg/24 h)的受试者。在空腹总血浆胆固醇和甘油三酯浓度、高血压发生率、糖尿病病程或糖尿病治疗类型方面,有微量白蛋白尿和无微量白蛋白尿的受试者之间没有显著差异。在多变量分析中,血糖水平(P < 0.005)和糖尿病诊断后的年限(P = 0.05)仍然与白蛋白排泄率独立相关。我们得出结论,在以诊所为基础的沙特阿拉伯NIDDM人群中,微量白蛋白尿极为常见,其存在与血糖控制密切相关。沙特阿拉伯糖尿病总体人群中微量白蛋白尿的患病率是否真的增加,现在必须等待进一步基于人群的研究。