Gomes M B, Lucchetti M R, Gazzola H, Dimetz T, Lobão V I, Stum J A
Hospital Universitário Pedro Ernesto-UERJ, Apoio CNPq.
Arq Bras Cardiol. 1997 Feb;68(2):85-9.
To determine the association between lipids, microalbuminuria and systemic blood pressure. Urinary albumin excretion rate (AER) was determined in timed overnight urine samples by radioimmunoassay. Microalbuminuria was defined when two out of three urine samples had AER ranging 20-200 micrograms/min. Lipids were determined by colorimetric methods (total cholesterol, HDL cholesterol and triglycerides).
Fifty patients with insulin dependent diabetes mellitus (28 females, 22 males) aged 21.9 +/- 7 years and with diabetes duration of 6.8 +/- 5.8 years attending the outpatients diabetes clinic were studied cross-sectionally.
Microalbuminuria was present in 12% of our patients. A high systolic blood pressure (SBP) was found in microalbuminuric patients (p = 0.003). No difference concerning serum lipids were found in comparison between normo and microalbuminuric patients, although 20% of all patients had increased cholesterol and LDL cholesterol and 4% had high HDL cholesterol and triglycerides levels. Stepwise multiple regression analysis showed that SBP was the only significant independent variable to influence AER (r = 0.42 r2 = 0.18 p = 0.002).
Although in our study, microalbuminuria was associated only with SBP, the independent alteration of lipids in young IDDM patients must be considered as a possible additional risk factor for cardiovascular disease.
确定脂质、微量白蛋白尿与全身血压之间的关联。通过放射免疫分析法在定时采集的过夜尿液样本中测定尿白蛋白排泄率（AER）。当三份尿液样本中有两份的AER在20 - 200微克/分钟范围内时，定义为微量白蛋白尿。脂质通过比色法测定（总胆固醇、高密度脂蛋白胆固醇和甘油三酯）。
对50名年龄为21.9±7岁、糖尿病病程为6.8±5.8年的胰岛素依赖型糖尿病患者（28名女性，22名男性）进行了横断面研究，这些患者均在门诊糖尿病诊所就诊。
我们的患者中有12%存在微量白蛋白尿。微量白蛋白尿患者的收缩压（SBP）较高（p = 0.003）。在正常白蛋白尿患者和微量白蛋白尿患者之间比较，未发现血脂有差异，尽管所有患者中有20%的胆固醇和低密度脂蛋白胆固醇升高，4%的高密度脂蛋白胆固醇和甘油三酯水平升高。逐步多元回归分析表明，SBP是影响AER的唯一显著独立变量（r = 0.42，r2 = 0.18，p = 0.002）。
虽然在我们的研究中，微量白蛋白尿仅与SBP相关，但年轻的胰岛素依赖型糖尿病患者脂质的独立改变必须被视为心血管疾病可能的额外危险因素。
