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目的系统评价躯体因素与2型糖尿病(T2DM)肾脏疾病的相关性。方法计算机检索MEDLINE、EMbase、CBM、CNKI和VIP数据库,收集所有关于T2DM肾脏疾病躯体危险因素的研究,检索时限截至2012年12月。由2名研究者按照纳入与排除标准筛选文献,提取数据和评价纳入研究的方法学质量后,采用RevMan5.2软件进行Meta分析。结果共纳入11个研究,12957例T2DM患者。其中9个研究为横断面研究,1个为病例-对照研究,1个为队列研究。研究结果显示:与T2DM肾脏疾病相关的躯体因素主要有糖尿病病程[OR=1.11,95%CI(1.05,1.18)]、腰围[OR=1.02,95%CI(1.00,1.04)]、空腹血糖[OR=1.11,95%CI(1.07,1.16)]、糖化血红蛋白[OR=1.20,95%CI(1.06,1.36)]、收缩压[OR=1.03,95%CI(1.02,1.05)]、舒张压[OR=2.41,95%CI(1.15,4.64)]、甘油三酯[OR=1.24,95%CI(1.02,1.51)]、高密度脂蛋白[OR=0.558,95%CI(0.369,0.844)]、血尿酸[OR=1.005,95%CI(1.002,1.009)]、血尿素氮水平[OR=1.58,95%CI(1.37,1.82)]、肾脏疾病史[OR=3.26,95%CI(1.20,8.87)]及肾脏疾病家族史[OR=1.83,95%CI(1.29,2.60)]。结论现有证据表明,与T2DM并发肾脏疾病相关的躯体因素众多。受纳入研究数量和质量所限,本研究结论尚需更多高质量研究进一步验证。
Objective To systematically evaluate the association between somatic factors and type 2 diabetes mellitus (T2DM) kidney disease. Methods The databases of MEDLINE, EMbase, CBM, CNKI and VIP were searched by computer, and all the risk factors of somatic body in T2DM kidney disease were collected. The search period was up to December 2012. After two investigators screened the literature for inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies, the RevMan5.2 software was used for meta-analysis. Results A total of 11 studies included 12,957 T2DM patients. Nine of the studies included cross-sectional studies, one case-control study and one cohort study. The results showed that the main physical factors associated with T2DM kidney disease were diabetes duration [OR = 1.11, 95% CI 1.05, 1.18], waist circumference [OR 1.02, 95% CI 1.00 1.00, fasting blood glucose OR = 1.11, 95% CI 1.07,1.16), HbA1c (OR = 1.20,95% CI 1.06,1.36), systolic blood pressure (OR = 1.03,95% CI (OR = 2.41, 95% CI 1.15,4.64), triglyceride [OR = 1.24,95% CI 1.02,1.51], high density lipoprotein [OR = 0.558,95% CI 0.369,0.844] (OR = 1.005,95% CI (1.002,1.009)], blood urea nitrogen level (OR = 1.58,95% CI 1.37,1.82), history of renal disease [OR = 3.26,95% CI 1.20, 8.87)] and a family history of renal disease [OR = 1.83, 95% CI (1.29, 2.60)]. Conclusions Available evidence suggests that there are many somatic factors associated with T2DM complicated with kidney disease. Due to the limited quantity and quality of the research, the conclusions of this study still need more high-quality research to further verify.