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.%To investigate the prevalence and risk factors of albuminuria in patients with type 2 diabetes mellitus ( T2DM ) in Shanghai communities. Methods The patients with T2DM under the control of communities in Shanghai were enrolled. Their data including demographic and clinical biochemical results were collected. The albuminuria condition was assessed through the ratio of albuminuria and creatinine ( ACR ) . Results A total of 2 044 patients, including 852 males and 1 192 females, with average age of ( 67. 6 ±9. 6 ) years, were investigated. The prevalence was 22. 7% for micro - albumineria ( MAU ) and 5. 0% for clinical albuminuria ( CAU ). The prevalence of albuminuria in diabetic patients was increasing with increases of age, glycosylated hemoglobin ( HbA1c) and duration of diabetes. Logistic regression analyses indicated that age=8O years, hypertension, HbA1c=7%, and triglyceride level were the risk factors of MAU. Duration of DM=10 years, hypertension and total cholesterol level were the risk factors of CAU. And high density lipoprotein - cholesterol (HDL-C) was the protective factor of CAU. Conclusion the prevalence of albuminuria was higher in type 2 diabetic patient. Diabetic nephropathy is related to blood pressure, body mass index (BMI), blood lipid and HbA,1c This shows the significance to lower blood pressure, control BMI, blood lipid and blood glucose in the prevention and treatment of diabetic nephropathies.
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