Factors associated with frequent remission of microalbuminuria in patients with type 2 diabetes
Factors associated with frequent remission of microalbuminuria in patients with type 2 diabetes
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DOI：
10.2337/diabetes.54.10.2983
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发表时间：
2005-10-01
期刊：
影响因子：
7.7
通讯作者：
Koya, D
中科院分区：
文献类型：
--
作者：
Araki, S;Haneda, M;Koya, D
为了估计日本2型糖尿病患者微量白蛋白尿缓解/消退的频率，并确定影响此类结果的因素，我们观察了216例2型糖尿病和微量白蛋白尿患者，在最初的2年评估期，在接下来的6年。缓解被定义为向正常蛋白尿的转移，消退被定义为尿白蛋白排泄率（AER）从一个2年到下一个2年减少50%。尿AER的减少是常见的，缓解期6年累积发生率为51% (95% Cl 42-60)，消退期为54%(45-63)，而进展为明显蛋白尿的频率为28%（19-37）。在合并logistic回归分析中，短时间微量白蛋白尿、肾素-血管紧张素系统阻断药物的使用、较低的HbA(1c)（< 6.95%）和收缩压（< 129 mmHg）与缓解或消退独立相关。结果表明，尿AER的减少在日本2型糖尿病患者中经常发生。微量白蛋白尿的早期检测和多因素控制可能会改善糖尿病肾病和心血管事件的预后。
To estimate the frequency of remission/regression of microalbuminuria and to identify factors affecting such outcomes in Japanese patients with type 2 diabetes, we observed 216 patients with type 2 diabetes and microalbuminuria enrolled during an initial 2-year evaluation period for the next 6 years. Remission was defined as shift to normoalbuminuria and regression as a 50% reduction in urinary albumin excretion rate (AER) from one 2-year period to the next. Reduction of urinary AER was frequent, with a 6-year cumulative incidence of 51% (95% Cl 42-60) for remission and 54% (45-63) for regression, whereas the frequency of progression to overt proteinuria was 28% (19-37). Microalbuminuria of short duration, the use of renin-angiotensin system-blocking drugs, and lower tertiles for HbA(1c) (< 6.95%) and systolic blood pressure (< 129 mmHg) were independently associated with remission or regression in the pooled logistic regression analysis. The results indicate that reduction in urinary AER occurs frequently in Japanese patients with type 2 diabetes. Early detection of microalbuminuria and a multifactorial control may result in improved outcomes for diabetic nephropathy and cardiovascular events.