An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the MicroAlbuminuria Prevalence (MAP) Study
An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the MicroAlbuminuria Prevalence (MAP) Study
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DOI：
10.1007/s00125-004-1599-9
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发表时间：
2005-01-01
期刊：
影响因子：
8.2
通讯作者：
Weir, MR
中科院分区：
文献类型：
--
作者：
Wu, AYT;Kong, NCT;Weir, MR
目的/假设：微量白蛋白尿是糖尿病肾病最早的临床证据，是心血管发病率和死亡率增加的标志。它的早期发现允许实施个性化和积极的干预计划，以减少心血管风险因素。关于亚洲高血压2型糖尿病患者中微量白蛋白尿患病率的信息有限。研究方法：这项横断面流行病学研究旨在评估10个亚洲国家或地区103个中心连续筛查的高血压2型糖尿病成人患者中微量白蛋白尿和大量白蛋白尿的患病率。微量白蛋白尿和大量白蛋白尿的预测因素采用逐步逻辑回归模型进行分析。结果如下：共入组6，801例患者，5，549例患者构成符合方案人群（排除菌尿和血尿患者）。微量白蛋白尿的患病率为39.8%（39.2-40.5; 95% CI），大量白蛋白尿的患病率为18.8%（18.2-19.3; 95% CI）。只有11.6%的患者收缩压和舒张压低于130/80 mm Hg目标。在多变量分析中，存在微量白蛋白尿的预测因素是年龄、BMI、收缩压和种族。存在大量白蛋白尿的突出预测因素是年龄、性别、种族、BMI、糖尿病病程、糖尿病并发症的存在、利尿剂的摄入、钙通道阻滞剂的摄入、舒张压和收缩压。结论/解释：在这些患者中观察到的微量或大量白蛋白尿的高患病率（58.6%）令人担忧，表明糖尿病心血管和肾脏疾病在亚洲即将流行，并具有潜在的经济后果。
Aims/hypothesis: Microalbuminuria represents the earliest clinical evidence of diabetic nephropathy and is a marker of increased cardiovascular morbidity and mortality. Its early detection allows the implementation of individualised and aggressive intervention programmes to reduce cardiovascular risk factors. There is limited information on the prevalence of microalbuminuria among hypertensive type 2 diabetic patients in Asia. Methods: This cross-sectional epidemiological study aimed to assess the prevalence of microalbuminuria and macroalbuminuria among consecutively screened hypertensive type 2 diabetic adult patients in 103 centres in 10 Asian countries or regions. Predictive factors for microalbuminuria and macroalbuminuria were characterised using a stepwise logistic regression model. Results: A total of 6,801 patients were enrolled and 5,549 patients constituted the per-protocol population (patients with bacteriuria and haematuria were excluded). The prevalence of microalbuminuria was 39.8% (39.2-40.5; 95% CI) and the prevalence of macroalbuminuria was 18.8% (18.2-19.3; 95% CI). Only 11.6% of the patients had systolic and diastolic blood pressure below the 130/80 mm Hg target. In the multivariate analyses, the predictive factors for the presence of microalbuminuria were age, BMI, systolic blood pressure and ethnic origin. The highlighted predictive factors for the presence of macroalbuminuria were age, sex, ethnic origin, BMI, duration of diabetes, presence of diabetic complications, intake of diuretics, intake of calcium channel blockers, diastolic and systolic blood pressure. Conclusions/interpretation: The high prevalence (58.6%) of micro or macroalbuminuria observed in these patients is alarming and indicates an impending pandemic of diabetic cardiovascular and renal diseases in Asia with its potential economic consequences.