南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (05): 697-.

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不同糖代谢状态人群慢性肾脏病的患病率及危险因素

肖倩蓉,范丽君,蒋薇,赵德福,万亨,潘道延,林旭,张彤,沈洁   

  • 出版日期:2016-05-20 发布日期:2016-05-20

Prevalence of chronic kidney disease and its risk factors in subjects with different glucose metabolism status

  • Online:2016-05-20 Published:2016-05-20

摘要: 目的探讨不同糖代谢状态人群的慢性肾脏病(CKD)患病率及危险因素。方法本横断面研究纳入2015年1月~2015年 10月于南方医科大学体检中心及内分泌科门诊就诊的患者共934例,其中糖尿病患者425例,糖尿病前期患者243例,血糖正常 人群266例,收集其一般资料及实验室检查等数据。CKD诊断标准采用:估算的肾小球滤过率(eGFR)<60 mL/min/1.73 m2和/ 或尿微量白蛋白与尿肌酐比值(ACR)≥30 mg/g,建立多元Logistic回归模型探讨糖尿病前期与CKD的关系。结果血糖正常 组、糖尿病前期组和糖尿病组的CKD患病率分别为10.2%,26.3%,32.5%。糖尿病前期患者的CKD患病率较血糖正常组升高 (P<0.001,OR=3.17,95% CI 1.94-5.17),糖尿病患者的CKD患病率较血糖正常组升高(P<0.001,OR=4.27,95% CI 2.72-6.65), 糖尿病前期患者与糖尿病患者相比,CKD患病率无明显差异(P=0.115,OR=1.35,95% CI 0.95-1.91)。Logistic回归模型分析显 示,校正性别、年龄、血压、高血压病史、血尿酸等混杂因素后,糖尿病前期(OR=2.03,95% CI 1.02-4.03,P=0.044)、糖尿病(OR= 2.22,95% CI 1.16-4.25,P=0.016)分别与CKD独立相关。结论糖尿病前期与CKD独立相关,因此提高糖尿病前期人群的检出 率和管理水平、积极从糖尿病前期就采取干预措施防治CKD是十分有必要的。

Abstract: Objective To investigate the prevalence of chronic kidney disease (CKD) in subjects with different glucose metabolism status. Methods Between January, 2015 and October, 2015, a total of 934 subjects without a previous diagnosis of diabetes visiting the Department of Endocrinology or Health Examination Center underwent oral glucose tolerance test (OGTT), which identified 266 subjects with normal glucose tolerance (NGT group), 243 pre-diabetic subjects, and 425 patients with diabetes mellitus group. The baseline characteristics and laboratory test data of the subjects were collected. The diagnosis of CKD was established for an eGFR <60 mL/min/1.73 m2 or a ACR≥30 mg/g, and the prevalence of CKD were compared among the 3 groups. Logistic regression model was used to analyze the OR value of the risk factors of CKD. Results The prevalences of CKD in NGT, pre-diabetic and diabetic groups were 10.2% , 26.3% and 32.5% , respectively. Pairwise comparisons showed that the prevalence of CKD was significantly higher in pre-diabetic group (P<0.001, OR=3.17, 95% CI 1.94-5.17) and diabetic group (P<0.001, OR=4.27, 95% CI 2.72-6.65) than in NGT group, and was comparable between the pre-diabetic and diabetic groups (P=0.115, OR=1.35, 95% CI 0.95-1.91). Logistic regression analysis, after adjustment for age, gender, blood pressure, hypertension, blood lipids and uric acid, showed that pre-diabetes (OR=2.03, P=0.044) and diabetes mellitus (OR=2.22, P=0.016) were independently associated with CKD. Conclusion Glucose metabolism status has a significant independent impact on the incidence of CKD, suggesting the importance of early detection of pre-diabetes and timely interventions in pre-diabetic subjects in prevention CKD.