摘要
目的 探讨微量白蛋白尿患病率与代谢综合征(MS)组分的关系。方法 选择3532例(男1622例,女1910例)年龄20岁以上的社区人群,测定其尿白蛋白、尿肌酐、体重指数、血压、腰围、臀围、空腹血糖、糖负荷后2 h血糖、血脂谱、空腹胰岛素。尿白蛋白/肌酐比30～300 mg/g诊断为微量白蛋白尿。结果 (1)微量白蛋白尿的患病率随年龄增长而增加(P<0.001),微量自蛋白尿组的腰臀比、收缩压、舒张压、甘油三酯、空腹血糖、胰岛素抵抗指数均明显高于无微量白蛋白尿组;(2)微量白蛋白尿的患病率随代谢紊乱的加重呈升高趋势(趋势分析P<0.001);(3)高血压和高血糖分别是微量白蛋白尿的独立影响因素(前者OR值=2.15,P<0.00l;后者OR值=1.64,P=0.01)。与无代谢异常组相比,二种代谢异常组和MS组发生微量蛋白尿的OR值显著升高,分别为3.93、4.77(P均<0.001)。结论 微量白蛋白尿患病率与高血压和高血糖独立相关,多种代谢异常集聚的个体发生微量自蛋白尿的风险显著增加,尤以MS为甚。
Objective To study the relationship between the prevalence of microalbuminuria and components of metabolic syndrome in Shanghai. Methods A total of 3532 Shanghai Chinese(men 1622, women 1910) aged over 20 years were included. Body mass index (BMI), blood pressure, fasting plasma glucose, lipid profile and plasma insulin concentrations were measured in all subjects. Oral glucose tolerance test was performed in those subjects without knowing the diabetic history. Urinary albumin-to-creatinine ratio(ACR) was measured in an early morning spot urine sample. Microalbuminuria was diagnosed when ACR was between 30 and 300 mg/g. Results (1) The prevalence of microalbuminuria was increasing with aging (P<0.001). When compared with subjects having normal ACR, the waist-hip ratio, systolic and diastolic pressure, serum triglyceride level, fasting plasma glucose and homeostasis model assessment-insulin resistance(HOMA-IR) were all significantly increased in those subjects with microalbuminuria. (2)Along with the increment of number of items on metabolic disorders, the prevalence of microalbuminuria was significantly increased ( P for trend < 0. 001). (3) Multiple logistic regression analyses revealed that hypertension and hyperglycemia were independent factors associated with microalbuminuria ( OR = 2.15, P<0.001 and QR= 1.64,P = 0.01 respectively). Those subjects with two or more items on metabolic disorders had higher odd ratio for the development of microalbuminuria ( OR = 3.93 and 4.77, both P< 0.001) when compared with the subjects without metabolic disorder. Conclusion The prevalence of microalbuminuria was independently associated with hypertension and hyperglycemia. The subjects with multiple metabolic abnormalities had higher risk for the development of microalbuminuria, especially in metabolic syndrome.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2004年第1期65-68,共4页
Chinese Journal of Epidemiology
基金
上海市医学领先专业重点学科基金(993024)
上海市医学发展基金重点项目(2001213002)
