Current smoking status may be associated with overt albuminuria in female patients with type 1 diabetes mellitus: a cross-sectional study.
Current smoking status may be associated with overt albuminuria in female patients with type 1 diabetes mellitus: a cross-sectional study.
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DOI：
10.1186/1617-9625-10-12
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发表时间：
2012-08-10
影响因子：
3.7
通讯作者：
Ishibashi S
中科院分区：
文献类型：
--
作者：
Okada K;Osuga J;Kotani K;Yagyu H;Miyamoto M;Nagasaka S;Ishibashi S
很少有临床报告比较了吸烟与亚洲1型糖尿病（T1 DM）患者微血管病变之间的关系。本研究的目的是评估T1 DM患者尿蛋白浓度与吸烟和基于性别的危险因素之间的关系。对2010年10月至2011年4月期间在我院就诊超过1年的259例T1 DM患者（男性/女性= 90/169;平均年龄，50.7岁）进行了一项横断面研究。参与者完成了一份关于他们吸烟习惯的问卷。患者特征包括性别、年龄、体重指数、血压、血红蛋白A1 c、血脂参数和微血管病变。根据以下尿白蛋白/肌酐比（ACR）水平，糖尿病肾病（DN）分为正常白蛋白尿（NA）、微量白蛋白尿（MA）或明显白蛋白尿（OA）：NA，ACR水平低于30 mg/g肌酐（Cr）; MA，ACR水平在30 - 299 mg/g Cr之间; OA，ACR水平超过300 mg/g Cr。目前不吸烟和目前吸烟的T1 DM患者百分比分别为73.0%（n = 189）和27.0%（n = 70）。此外，在目前的吸烟人口中，男性的比例高于女性（52.2%对13.6%）。NA组DN发生率为61.8%（n = 160），MA组为21.6%（n = 56），OA组为16.6%（n = 43）。OA患者中男性的百分比也高于女性（24.4%对12.4%）。然而，目前的吸烟状况仅与T1 DM女性患者的OA相关[未校正的比值比（OR），4.13; 95%置信区间（CI），1.45-11.73，P < 0.01;多变量校正的OR，5.41; 95% CI，1.69-17.30，P < 0.01]。根据我们在亚洲T1 DM患者中的横断面研究结果，吸烟可能是女性患者OA的一个风险因素。需要对这些按性别区分的结果进行进一步研究。
There are very few clinical reports that have compared the association between cigarette smoking and microangiopathy in Asian patients with type 1 diabetes mellitus (T1DM). The objective of this study was to assess the relationships between urinary protein concentrations and smoking and gender-based risk factors among patients with T1DM. A cross-sectional study of 259 patients with T1DM (men/women = 90/169; mean age, 50.7 years) who visited our hospital for more than 1 year between October 2010 and April 2011 was conducted. Participants completed a questionnaire about their smoking habits. Patient characteristics included gender, age, body mass index, blood pressure, hemoglobin A1c, lipid parameters, and microangiopathy. Diabetic nephropathy (DN) was categorized as normoalbuminuria (NA), microalbuminuria (MA), or overt albuminuria (OA) on the basis of the following urinary albumin/creatinine ratio (ACR) levels: NA, ACR levels less than 30 mg/g creatinine (Cr); MA, ACR levels between 30 and 299 mg/g Cr; and OA, ACR levels over 300 mg/g Cr. The percentages of current nonsmokers and current smokers with T1DM were 73.0% (n = 189) and 27.0% (n = 70), respectively. In addition, the percentage of males was higher than that of females (52.2% versus 13.6%) in the current smoking population. The percentage of DN was 61.8% (n = 160) in patients with NA, 21.6% (n = 56) in patients with MA, and 16.6% (n = 43) in patients with OA. The percentage of males among OA patients was also higher than that of females (24.4% versus 12.4%). However, current smoking status was associated with OA in females with T1DM only [unadjusted odds ratio (OR), 4.13; 95% confidence interval (CI), 1.45–11.73, P < 0.01; multivariate-adjusted OR, 5.41; 95% CI, 1.69–17.30, P < 0.01]. Based on our results in this cross-sectional study of Asian patients with T1DM, smoking might be a risk factor for OA among female patients. Further research is needed of these gender-specific results.
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