Risk factors for development of incipient and overt diabetic nephropathy in type 1 diabetic patients - A 10-year prospective observational study
Risk factors for development of incipient and overt diabetic nephropathy in type 1 diabetic patients - A 10-year prospective observational study
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DOI：
10.2337/diacare.25.5.859
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发表时间：
2002-05-01
期刊：
影响因子：
16.2
通讯作者：
Parving, HH
中科院分区：
文献类型：
--
作者：
Rossing, P;Hougaard, P;Parving, HH
目的-评估前瞻性推定的风险因素发展的微量白蛋白尿和macroalbuminuria在1型diabetes.RESEARCH设计和方法-前瞻性观察性研究队列的1型糖尿病患者在Steno糖尿病中心门诊随访大于或等于10年（中位数9年）。我们随访了537例年龄≥ 18岁的1型糖尿病患者，糖尿病病程≥ 5年，尿白蛋白正常（尿白蛋白排泄率：30 mg/24 h）。并且没有服用降压药。微量白蛋白尿和大量atbuminuria.RESULTS发展的危险因素-尿白蛋白排泄率的平均进展为7.6%（SE 0.8）每年。在随访期间，134例患者（25%）进展为持续性微量白蛋白尿或大量白蛋白尿（3个连续尿样中有2个>30 mg/24 h）。使用假定进展预测因子的基线值进行的考克斯多元回归分析显示，以下是从正常白蛋白尿进展为微量白蛋白尿或大量白蛋白尿的显著预测因子：基线log尿白蛋白排泄率2.63（相对危险度95% CI 1.65-4.19）、HbA（1C）1.13%（1.04-1.23）、存在任何视网膜病变1.90（1.26-2.88）和吸烟1.61（1.11-2.33）。性别，糖尿病持续时间，动脉血压，血清肌酐，身高和社会阶层不是危险因素。结论-我们的研究表明，几个潜在的可改变的危险因素预测1型糖尿病患者微量白蛋白尿和大量白蛋白尿的发展。
OBJECTIVE - To evaluate prospectively putative risk factors for development of microalbuminuria and macroalbuminuria in type 1 diabetes.RESEARCH DESIGN AND METHODS - prospective observational study of a cohort of type 1 diabetic patients followed in the Outpatient clinic at Steno Diabetes Center for greater than or equal to10 years (median 9 years). We followed 537 patients aged greater than or equal to18 years With type 1 diabetes, With duration of diabetes greater than or equal to5 years, with normoalbuminuria (urinary albumin excretion rate : 30 mg/24 h). and who were not taking antihypertensive medication. Risk factors for development of microalbuminuria and macroatbuminuria were evaluated.RESULTS - The mean progression of urinary albumin excretion rate was 7.6% (SE 0.8) per year. During follow-up, 134 patients (25%) progressed to persistent microalbuminuria or macroalbuminuria (>30 mg/24 h in two of three consecutive urine samples). Cox multiple regression analysis using baseline values of putative predictors of progression showed the following significant predictors of progression from normoalbuminuria to microalbummuria or macroalbuminuria: baseline log urinary albumin excretion rate 2.63 (relative risks 95% Cl 1.65-4.19), HbA(1C) 1.13% (1.04-1.23), presence of any retinopathy 1.90 (1.26-2.88), and smoking 1.61 (1.11-2.33). Sex, duration of diabetes, arterial blood pressure, serum creatinine, height, and social class were not risk factors.CONCLUSIONS - Our study suggests that several Potentially modifiable risk factors predict the development of microalbuminuria and macroalbuminuria in type 1 diabetic patients.