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目的了解上海市社区糖尿病人群清蛋白尿的患病情况及相关危险因素。方法选择上海市社区卫生服务机构管理的2型糖尿病患者,收集患者的临床资料(包括人口学资料和实验室检查结果),根据尿清蛋白/尿肌酐比值(ACR)来评价糖尿病患者的清蛋白尿情况。结果共调查了2 044例患者,其中男性852例,女性1 192例,平均年龄(67.6±9.6)岁。微量清蛋白尿占22.7%,临床清蛋白尿占5.0%。糖尿病患者中清蛋白尿的患病率随着年龄、糖化血红蛋白和病程的增长而增高。Logistic回归分析显示,年龄≥80岁、高血压、糖化血红蛋白≥7%和三酰甘油(TG)水平是糖尿病患者发生微量清蛋白尿的独立危险因素;病程≥10年、高血压和总胆固醇(TC)水平是糖尿病患者发生临床清蛋白尿的独立危险因素,高密度脂蛋白胆固醇(HDL-C)则是糖尿病患者避免发生临床清蛋白尿的保护因素。结论上海市社区糖尿病患者中清蛋白尿的患病率较高,糖尿病肾病可能与血压、体质量、血脂和血糖相关,提示降低血压、控制体质量、控制血脂和血糖对预防和治疗糖尿病肾病有着很大的重要性。
Objective To understand the prevalence and related risk factors of albuminuria in community diabetic population in Shanghai. Methods Patients with type 2 diabetes who were managed by community health service agencies in Shanghai were enrolled. Clinical data (including demographic data and laboratory test results) of patients were collected. Urine albumin / creatinine ratio (ACR) was used to evaluate albumin Urine situation. Results Totally 2 044 patients were investigated, including 852 males and 192 females, with an average age of 67.6 ± 9.6 years. Microalbuminuria accounted for 22.7%, clinical albuminuria accounted for 5.0%. The prevalence of albuminuria in diabetics increases with age, glycohemoglobin, and duration of disease. Logistic regression analysis showed that age ≥80 years old, hypertension, glycosylated hemoglobin≥7% and triglyceride (TG) were independent risk factors of microalbuminuria in diabetic patients. The duration of disease was more than 10 years, hypertension and total cholesterol TC) is an independent risk factor for clinical albuminuria in diabetic patients. High-density lipoprotein cholesterol (HDL-C) is a protective factor against clinical albuminuria in diabetic patients. Conclusion The prevalence of albuminuria in community diabetic patients in Shanghai is high. Diabetic nephropathy may be related to blood pressure, body weight, blood lipids and blood glucose, suggesting that lowering blood pressure, controlling body weight, controlling blood lipids and blood sugar have the effect on the prevention and treatment of diabetic nephropathy Great importance.