Kim C H, Kim H K, Park J Y, Park H S, Hong S K, Park S W, Lee K U
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Diabetes Res Clin Pract. 1998 Jun;40(3):191-9. doi: 10.1016/s0168-8227(98)00029-1.
Microalbuminuria in non-diabetic subjects is reportedly associated with increased cardiovascular morbidity and mortality. The prevalence of microalbuminuria in non-diabetic subjects varies widely from 5-6% in the UK and USA to 30-55% in Finland, Mexico, or Australian Aborigines. We studied cross-sectionally 497 clinically healthy, non-diabetic subjects more than 40 years of age who were living in Seoul, Korea for the prevalence of microalbuminuria and various cardiovascular risk factors. Urinary albumin-to-creatinine ratio (UACR) was determined in morning spot urine samples. Subjects were divided into normoalbuminuria (UACR < 2 mg/mmol) and microalbuminuria (UACR > or = 2 mg/mmol) groups. A total of 61 (12.2%) out of 497 subjects were found to have microalbuminuria. Subjects with microalbuminuria had significantly higher values in age, body mass index (BMI), waist-to-hip ratio in women, systolic and diastolic blood pressure, prevalence of hypertension, plasma cholesterol and triglyceride, and fasting plasma insulin. When subjects with microalbuminuria were compared with age-, sex-, and BMI-matched controls without microalbuminuria, systolic and diastolic blood pressure, and fasting plasma insulin concentrations were higher in microalbuminuric subjects. Multiple logistic regression analysis showed that fasting plasma insulin level and systolic blood pressure were independently associated with microalbuminuria. These results indicate that the prevalence of microalbuminuria in Korean non-diabetic subjects is lower than that in Mexico and Finland, but similar to that in Caucasians from the UK and USA, or in Pima Indians. Also, microalbuminuria in Korean non-diabetic subjects is associated with atherosclerotic risk factors such as hyperinsulinemia and hypertension, suggesting that microalbuminuria in these subjects may be a feature of insulin resistance syndrome.
据报道，非糖尿病患者的微量白蛋白尿与心血管疾病发病率和死亡率的增加有关。非糖尿病患者中微量白蛋白尿的患病率差异很大，在英国和美国为5%-6%，而在芬兰、墨西哥或澳大利亚原住民中则为30%-55%。我们对497名居住在韩国首尔、年龄超过40岁的临床健康非糖尿病受试者进行了横断面研究，以调查微量白蛋白尿和各种心血管危险因素的患病率。通过检测晨尿样本中的尿白蛋白肌酐比值（UACR）来确定尿白蛋白水平。受试者被分为正常白蛋白尿组（UACR<2mg/mmol）和微量白蛋白尿组（UACR≥2mg/mmol）。497名受试者中共有61名（12.2%）被发现患有微量白蛋白尿。微量白蛋白尿患者在年龄、体重指数（BMI）、女性腰臀比、收缩压和舒张压、高血压患病率、血浆胆固醇和甘油三酯以及空腹血浆胰岛素水平方面的值显著更高。当将微量白蛋白尿患者与年龄、性别和BMI相匹配的无微量白蛋白尿对照组进行比较时，微量白蛋白尿患者的收缩压、舒张压和空腹血浆胰岛素浓度更高。多因素logistic回归分析表明，空腹血浆胰岛素水平和收缩压与微量白蛋白尿独立相关。这些结果表明，韩国非糖尿病患者中微量白蛋白尿的患病率低于墨西哥和芬兰，但与来自英国和美国的白种人或皮马印第安人相似。此外，韩国非糖尿病患者的微量白蛋白尿与高胰岛素血症和高血压等动脉粥样硬化危险因素相关，这表明这些患者的微量白蛋白尿可能是胰岛素抵抗综合征的一个特征。
