González Villalpando C, Stern M P, Arredondo Pérez B, Martínez Díaz S, Islas Andrade S, Revilla C, González Villalpando M E, Rivera Martínez D
Centro de Estudios en Diabetes, American British Cowdray Hospital, México, D.F.
Arch Med Res. 1996 Autumn;27(3):367-72.
Among the most serious complications associated with diabetes mellitus (DM) is nephropathy (DN). In Mexico, there is little information on the frequency and clinical characteristics of DN in the Mexican population. We present results of a population-based survey designed to estimate the prevalence of DN. The low income population consisted of 15,532 inhabitants. All 35- to 64-year-old males and non-pregnant women residing in the survey area were identified as eligible for the study (3505; 22.6%). A home interview was obtained in 2810 (80.2%). A physical exam with oral glucose tolerance test was obtained in 2282 (81.2% of those interviewed). DM was diagnosed in 304 (crude rate 13.3%). Mean age for men and women with DM was 51.6 +/- 8.4 and 52.2 +/- 7.5, respectively. Duration of DM in men was 9.2 +/- 8.1 and in women, 7.3 +/- 6.7 years. Hypertension was diagnosed in 19.8% of men and 18.1% of women. Diabetic retinopathy of any level was found in 55.4% of men and 45.7% of women. Mean glycohemoglobin in men was 9.6 +/- 2.1 and in women 9.5 +/- 2.2% (normal 4-8%). At baseline, proteinuria (1+ or more, by dipstick) was found in 24.7% of men and 9.6% of women, microalbuminuria (MA) in 84.4% of men and 63.8% of women. Quantitative albuminuria was abnormally high in 54.7% of men and 40.3% of women. In the 203 diabetics studied with 24 h urine collection for creatinine clearance, normal renal function was found in 69.1% of men and 47.5% of women, reduced renal function was found in 26% of men and 50% of women, renal insufficiency was diagnosed in 4.9% of men and 1.6% of women. One patient was on dialysis and in a subsequent follow up, we found that 2.3% of the patients had died of renal failure, six men (46-63 years) and a woman of 62 years. We conclude that DN is a very serious threat to this population. The high case fatality rate associated with this condition maintains a low prevalence. It is important to develop a program to diminish the frequency of this condition.
糖尿病（DM）最严重的并发症之一是肾病（DN）。在墨西哥，关于墨西哥人群中DN的发病率和临床特征的信息很少。我们展示了一项基于人群的调查结果，旨在估计DN的患病率。低收入人群包括15532名居民。所有居住在调查区域的35至64岁男性和非妊娠女性被确定为符合研究条件（3505人；22.6%）。2810人（80.2%）接受了家庭访谈。2282人（占接受访谈者的81.2%）接受了包括口服葡萄糖耐量试验在内的体格检查。诊断出糖尿病患者304人（粗发病率13.3%）。男性和女性糖尿病患者的平均年龄分别为51.6±8.4岁和52.2±7.5岁。男性糖尿病病程为9.2±8.1年，女性为7.3±6.7年。19.8%的男性和18.1%的女性被诊断为患有高血压。任何程度的糖尿病视网膜病变在55.4%的男性和45.7%的女性中被发现。男性糖化血红蛋白平均为9.6±2.1%，女性为9.5±2.2%（正常范围4 - 8%）。基线时，24.7%的男性和9.6%的女性出现蛋白尿（试纸检测1+或更高），84.4%的男性和63.8%的女性出现微量白蛋白尿（MA）。54.7%的男性和40.3%的女性定量白蛋白尿异常高。在203名进行24小时尿肌酐清除率检测的糖尿病患者中，69.1%的男性和47.5%的女性肾功能正常，26%的男性和50%的女性肾功能减退，4.9%的男性和1.6%的女性被诊断为肾功能不全。一名患者正在接受透析，在随后的随访中，我们发现2.3%的患者死于肾衰竭，6名男性（46 - 63岁）和一名62岁女性。我们得出结论，DN对该人群是一个非常严重的威胁。与这种疾病相关的高病死率导致其患病率较低。制定一个降低这种疾病发病率的项目很重要。
