CAJ | 학술논문

目的比较社区正常糖耐量(NGT)、糖调节受损(IGR)及新诊断2型糖尿病(T2DM)人群伴随代谢综合征(MS)组分及微量白蛋白尿(MAU)的患病情况,并分析MAU的危险因素.方法根据口服葡萄糖耐量试验结果,将951例受试者分为NGT组674例,IGR组195例,新诊断T2DM组82例.采用2007年中国成人血脂异常防治指南中关于MS的诊断标准；以尿微量白蛋白/肌酐(UACR)表示尿白蛋白排泄率,UACR 30 ～ 300 mg/g诊断为MAU.结果 (1)与NGT组相比,IGR组和新诊断T2DM组的年龄、体质指数(BMI)、腰围、空腹血糖、餐后2h血糖(2 hPG)、糖化血红蛋白、糖化血清白蛋白、空腹胰岛素水平、胰岛素抵抗指数、甘油三酯、收缩压(SBP)、UACR均较高,而高密度脂蛋白胆固醇均较低(均P ＜0.05).(2)IGR组和新诊断T2DM组的MS、MAU患病率分别为54.4％ (106/195)、12.3％ (24/195)和61.0％ (50/82)、12.2％( 10/82),NGT组MS、MAU患病率为9.1％ (61/674)、4.9％ (33/674),IGR组和新诊断T2DM组MS、MAU患病率均明显高于NGT组(均P＜0.05).(3)多元逐步回归显示BMI、SBP及2 hPG与UACR呈独立正相关.Logistic回归结果显示BMI、SBP、2 hPG为MAU的独立危险因素.结论 IGR和新诊断T2DM人群MS各组分及MS、MAU患病率均明显升高.BMI、SBP、2 hPG为MAU的独立危险因素.
목적 비교사구정상당내량(NGT)、당조절수손(IGR)급신진단2형당뇨병(T2DM)인군반수대사종합정(MS)조분급미량백단백뇨(MAU)적환병정황,병분석MAU적위험인소.방법 근거구복포도당내량시험결과,장951례수시자분위NGT조674례,IGR조195례,신진단T2DM조82례.채용2007년중국성인혈지이상방치지남중관우MS적진단표준；이뇨미량백단백/기항(UACR)표시뇨백단백배설솔,UACR 30 ～ 300 mg/g진단위MAU.결과 (1)여NGT조상비,IGR조화신진단T2DM조적년령、체질지수(BMI)、요위、공복혈당、찬후2h혈당(2 hPG)、당화혈홍단백、당화혈청백단백、공복이도소수평、이도소저항지수、감유삼지、수축압(SBP)、UACR균교고,이고밀도지단백담고순균교저(균P ＜0.05).(2)IGR조화신진단T2DM조적MS、MAU환병솔분별위54.4％ (106/195)、12.3％ (24/195)화61.0％ (50/82)、12.2％( 10/82),NGT조MS、MAU환병솔위9.1％ (61/674)、4.9％ (33/674),IGR조화신진단T2DM조MS、MAU환병솔균명현고우NGT조(균P＜0.05).(3)다원축보회귀현시BMI、SBP급2 hPG여UACR정독립정상관.Logistic회귀결과현시BMI、SBP、2 hPG위MAU적독립위험인소.결론 IGR화신진단T2DM인군MS각조분급MS、MAU환병솔균명현승고.BMI、SBP、2 hPG위MAU적독립위험인소.
Objective To examine the prevalence of metabolic syndrome (MS) and microalbuminuria (MAU) in subjects with different levels of glucose tolerance and probe the risk factors for the development of MAU.Methods A total of 951 subjects were divided into 3 groups according to the results of oral glucose tolerance test (OGTT).Among them,there were 674 subjects with normal glucose tolerance (NGT),195 with impaired glucose regulation (IGR) and 82 newly-diagnosed cases of type 2 diabetes mellitus (T2DM). MAU was diagnosed if urine albumin-to-creatinine ratio (UACR) was 30 - 300 mg/g.Results ( 1 ) Compared to the NGT subjects,both the IGR and newly-diagnosed T2DM subjects had the significantly higher levels of age,body mass index (BMI),waist circumference,fasting plasma glucose,2-hour post OGTT glucose (2 hPG),glycated hemoglobin,glycated albumin,fasting insulin,homeostasis model of assessment-insulin resistance (HOMA-IR),triglyceride,systolic blood pressure (SBP) and UACR but a lower level of high density lipoprotein-cholesterol (HDL-C) ; (2) The incident rate of MS and MAU in the IGR and newly-diagnosed T2DM subjects was 54.4％ ( 106/195 ),12.3％ (24/195) and 61.0％ (50/82),12.2％ (10/82) respectively versus 9.1％ (61/674) and 4.9％ (33/674) in the NGT subjects.The incident rate of abdominal obesity,hypertension,hypertriglyceridemia,low HDL-C,MS and MAU in the IGR and newly-diagnosed T2DM subjects was significantly higher than that of the NGT subjects ( all P ＜ 0.05 ) ; (3) Multiple regression analysis showed that BMI,SBP and 2 hPG were independently associated with UACR.Logistic regression analysis indicated that BMI,SBP and 2 hPG were independent risk factors of MAU.Conclusions The prevalence of MS and MAU is significantly higher in the IGR and newly-diagnosed T2DM subjects.BMI,SBP and 2 hPG are independent risk factors of MAU.