Araki S, Haneda M, Togawa M, Sugimoto T, Shikano T, Nakagawa T, Isono M, Hidaka H, Kikkawa R
Third Department of Medicine, Shiga University of Medical Science, Japan.
Diabetes Res Clin Pract. 1997 Feb;35(1):35-40. doi: 10.1016/s0168-8227(96)01361-7.
To evaluate whether the presence of microalbuminuria can predict cardiovascular death in Japanese subjects with non-insulin-dependent diabetes mellitus (NIDDM), we investigated 297 Japanese NIDDM patients with Albustix-negative urine. Patients were divided into two groups, normoalbuminuric (n = 201) and microalbuminuric (n = 96) and followed until death or the end of 1994 (the mean follow-up period was 6.4 years). During the follow-up period, 28 deaths (14 normoalbuminuric and 14 microalbuminuric patients) were confirmed and only 10 deaths were attributed to cardiovascular disease (6 normoalbuminuric and 4 microalbuminuric patients). Although the age- and sex-adjusted mortality rate from all-causes in the microalbuminuric group was significantly higher than that in the normoalbuminuric group (13.5 vs. 8.2 per 1000 person-years: P < 0.05), the mortality rate from cardiovascular disease was not significantly different between two groups (3.4 vs. 3.3 per 1000 person-years). On age-adjusted Cox proportional hazards analysis. HbA1c and triglyceride were independent risk factors in mortality from cardiovascular disease, while microalbuminuria was not associated with cardiovascular death. These results indicate that, unlike Caucasians, the presence of microalbuminuria can not predict cardiovascular death in Japanese subjects with NIDDM.
为评估微量白蛋白尿的存在是否能预测日本非胰岛素依赖型糖尿病（NIDDM）患者的心血管死亡，我们调查了297例尿Albustix检测呈阴性的日本NIDDM患者。患者被分为两组，即正常白蛋白尿组（n = 201）和微量白蛋白尿组（n = 96），并随访至死亡或1994年底（平均随访期为6.4年）。在随访期间，确认有28例死亡（14例正常白蛋白尿患者和14例微量白蛋白尿患者），其中仅10例死亡归因于心血管疾病（6例正常白蛋白尿患者和4例微量白蛋白尿患者）。尽管微量白蛋白尿组经年龄和性别调整后的全因死亡率显著高于正常白蛋白尿组（每1000人年分别为13.5和8.2：P < 0.05），但两组间心血管疾病死亡率无显著差异（每1000人年分别为3.4和3.3）。经年龄调整的Cox比例风险分析显示，糖化血红蛋白（HbA1c）和甘油三酯是心血管疾病死亡的独立危险因素，而微量白蛋白尿与心血管死亡无关。这些结果表明，与高加索人不同，微量白蛋白尿的存在不能预测日本NIDDM患者的心血管死亡。
