Esmatjes E, Castell C, Goday A, Montanya E, Pou J M, Salinas I, Simó R, González M T, Tresserras R, Lloveras G
Servicio de Endocrinología, Hospital Clínic i Provincial de Barcelona.
Med Clin (Barc). 1998 Jan 17;110(1):6-10.
Diabetic nephropathy is a serious complication of diabetes, of which there are few epidemiological data in Spain. The aim of this study is to determine diabetic nephropathy prevalence in a group of patients with type I diabetes mellitus, representative of the population of Barcelona, Spain, evaluating several risk factors related with its development.
639 patients (296 males and 343 women), from 6 hospitals, selected according with the diabetes duration (194 between 5 and 9 years [group I], 227 between 10 and 19 years [group II] and 218 with 20 years or more [group III]) were studied. In all patients urinary albumin excretion and plasma levels of creatinine, HbA1c, cholesterol and triglycerides were determined. The presence of retinopathy, neuropathy, vasculopathy and tobacco consumption were also evaluated.
The prevalence of diabetic nephropathy increased with longer diabetes duration (8.1% [CI: 4.3-11.9] in group I, 24.7% [CI: 19.1-30.3] in group II and 44.7% [CI: 38.1-51.3] in group III), as well as that of hypertension, diabetes complications, cholesterol and triglycerides plasma levels. Related to people with normal renal function, after logistic regression, microalbuminuria was associated with hypertension and longer diabetes duration. Clinical nephropathy (macroalbuminuria + renal failure) to hypertension, longer duration, hypertriglyceridemia, male sex and tobacco consumption.
The prevalence of diabetic nephropathy in Barcelona area is high and similar to that observed in other european regions. Its existence is associated with other diabetic complications. In addition to the classic risk factors, tobacco consumption must also be considered as a factor for diabetic nephropathy.
糖尿病肾病是糖尿病的一种严重并发症，西班牙关于其流行病学数据较少。本研究旨在确定一组代表西班牙巴塞罗那人群的1型糖尿病患者中糖尿病肾病的患病率，并评估与其发生相关的多种风险因素。
选取了来自6家医院的639例患者（296例男性和343例女性），根据糖尿病病程进行分组（5至9年的194例[第一组]，10至19年的227例[第二组]，20年及以上的218例[第三组]）。测定了所有患者的尿白蛋白排泄率以及血浆肌酐、糖化血红蛋白、胆固醇和甘油三酯水平。还评估了视网膜病变、神经病变、血管病变和吸烟情况。
糖尿病肾病的患病率随糖尿病病程延长而增加（第一组为8.1%[可信区间：4.3 - 11.9]，第二组为24.7%[可信区间：19.1 - 30.3]，第三组为44.7%[可信区间：38.1 - 51.3]），高血压、糖尿病并发症、胆固醇和甘油三酯血浆水平的患病率也随病程延长而增加。与肾功能正常者相比，经逻辑回归分析，微量白蛋白尿与高血压和较长的糖尿病病程相关。临床肾病（大量白蛋白尿 + 肾衰竭）与高血压、较长病程、高甘油三酯血症、男性性别和吸烟有关。
巴塞罗那地区糖尿病肾病的患病率较高，与其他欧洲地区观察到的情况相似。其存在与其他糖尿病并发症相关。除了经典的风险因素外，吸烟也必须被视为糖尿病肾病的一个因素。
