Nelson R G, Knowler W C, Pettitt D J, Hanson R L, Bennett P H
Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, USA.
Diabetes Care. 1995 Feb;18(2):182-7. doi: 10.2337/diacare.18.2.182.
To examine the incidence and determinants of elevated urinary albumin excretion in Pima Indians with non-insulin-dependent diabetes mellitus (NIDDM).
The incidence of elevated urinary albumin excretion (> or = 30 mg albumin/g creatinine) and its relationship with baseline characteristics was determined in 456 Pima Indians > or = 15 years old with NIDDM who were followed for up to 11.6 years (median 4.7 years).
Of these 456 subjects, 192 (42%; 58 men, 134 women) developed elevated urinary albumin excretion, 172 of whom (90%) were within the microalbuminuric range (30-299 mg/g). The incidence of elevated urinary albumin excretion was related to retinopathy, type, of diabetes treatment, longer duration of diabetes, lower body mass index, and higher values of mean arterial pressure, HbA1, and fasting and 2-h postload plasma glucose concentration at the baseline examination, but not to sex. A relationship with cholesterol was found in durations of diabetes of > or = 10 years. The cumulative incidence of elevated albumin excretion was 17% after 5 years of NIDDM.
The incidence of elevated urinary albumin excretion in Pima Indians with NIDDM is at least as high as that reported previously in insulin-dependent diabetes mellitus, and its major determinants are the same as those shown previously to predict the development of more advanced renal disease in this population.
研究非胰岛素依赖型糖尿病（NIDDM）皮马印第安人中尿白蛋白排泄增加的发生率及其决定因素。
在456名年龄≥15岁的NIDDM皮马印第安人中，确定尿白蛋白排泄增加（≥30mg白蛋白/克肌酐）的发生率及其与基线特征的关系，这些患者随访长达11.6年（中位数4.7年）。
在这456名受试者中，192人（42%；58名男性，134名女性）出现尿白蛋白排泄增加，其中172人（90%）处于微量白蛋白尿范围（30 - 299mg/g）。尿白蛋白排泄增加的发生率与视网膜病变、糖尿病治疗类型、糖尿病病程较长、体重指数较低以及基线检查时平均动脉压、糖化血红蛋白（HbA1）、空腹及餐后2小时血浆葡萄糖浓度较高有关，但与性别无关。在糖尿病病程≥10年时发现与胆固醇有关。NIDDM 5年后白蛋白排泄增加的累积发生率为17%。
NIDDM皮马印第安人中尿白蛋白排泄增加的发生率至少与先前报道的胰岛素依赖型糖尿病一样高，其主要决定因素与先前显示的预测该人群更晚期肾病发生的因素相同。
