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頁籤選單縮合
題 名 | The Prevalence and Risk Factors of Diabetic Nephropathy in Taiwanese Type 2 Diabetes--A Hospital-Based Study=第2型糖尿病病人之糖尿病腎臟病變的盛行率相關危險因子 |
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作 者 | 沈峰志; 陳敕因; 蘇聖棋; 劉瑞川; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷 期 | 23:2 2009.06[民98.06] |
頁 次 | 頁90-95+127 |
分類號 | 415.6681 |
關鍵詞 | 第2型糖尿病; 糖尿病腎臟病變; 微量白蛋白尿; 白蛋白尿; Type 2 diabetes; Diabetic nephropathy; Microalbuminuria; Macroalbuminuria; |
語 文 | 英文(English) |
中文摘要 | 背景:糖尿病腎臟病變是造成末期腎病變(endstage renal disease, ESRD)最主要的原因而且與心血管疾病有關係。在最近的研究報告顯示在亞洲地區第2型糖尿病人有較高的糖尿病腎臟病變盛行率。因此本篇研究主要目的是去統計糖尿病腎臟病變的盛行率並且探討糖尿病腎臟病變的相關危險因子。研究方法:本篇研究總共收集了1069位第2型糖尿病患者來做分析。我們依據這些患者的尿液白蛋白流失率(albumin excretion rate, AER)來分組,根據所收集的傳統及非傳統危險因子來做相關的分析。結果:正常白蛋白尿、微量白蛋白尿以及白蛋白尿的盛行率分別為60.3、27.0以及12.7%。在單變項分析中發現年紀、罹患糖尿病的時間、腹圍、身體質量指數(body mass index, BMI)、血清肌酸酐、糖化血色素、高密度脂蛋白膽固醇(HDL-C)、三酸甘油脂(Triglyceride)、視網膜病變、胰島素的使用以及使用腎素-血管張力素系統(rennin-angiotensin system, RAS)阻斷劑與糖尿病腎臟病變有關。再把這些相關因子做多變項分析則發現只有罹患糖尿病時間、腹圍、血清肌酸酐、糖化血色素、三酸甘油脂、視網膜病變以及使用腎素-血管張力素系統阻斷劑為獨立因子。結論:我們的研究顯示糖尿病腎病變的盛行率約為40%,這跟在歐洲或高加索種族所統計的盛行率並無不同。本篇所得到有意義的危險因子也跟過去研究所討論的危險因子相當。因此有效的控制這些危險因子將可以降低第2型糖尿病病人進展到糖尿病腎臟病變的機會。 |
英文摘要 | Background: Diabetic nephropathy is the major cause of end-stage renal disease and is associated with cardiovascular morbidity and mortality. Recent data reported a high prevalence of diabetic nephropathy in Asian type 2 diabetic patients. The aims of this study were to determine the prevalence of diabetic nephropathy (microalbuminuria or macroalbuminuria) in type 2 diabetes and to identify the risk factors for nephropathy in this population. Method: A total of 1069 type 2 diabetic patients were recruited in this cross-sectional study and they were stratified according to urinary albumin excretion rate, The association between diabetic nephropathy and its traditional and nontraditional risk factors was analyzed. Results: The prevalence of normo-, micro- and macroalbuminuria was 60.3, 27.0 and 12.7%, respectively. Many factors differed between patients with and without diabetic nephropathy, including age, duration of diabetes, waist circumference, body mass index (BMI), serum creatinine, hemoglobin A1c (HbA1c), high-density lipoprotein (HDL)-cholesterol, triglyceride, presence of retinopathy, insulin use and use of rennin-angiotensin system (RAS) blockades. Multivariate regression analysis revealed that only duration of diabetes (OR: 1.029, 95% CI: 1.001-1.057, p=0.042); waist circumference (OR: 1.047, 95% CI: 1.016 1.078, P<0.005); serum creatinine (OR: 1.821, 95% CI: 1.244-2.666 P<0.005), HbA1c (OR: 1.276, 95% CI: 1.134-1.437, P<0.005), triglyceride (OR: 1.002, 95% CJ:1.000-1.004, P=0.033); retinopathy (OR: 2.372, 95% CI:1.647-3.415, P<0.005); and use of RAS blockades (OR: 0.514, 95% CI: 0.368-0.718, P<0.005) were independent risk factors. Conclusions: The prevalence (40 %) of diabetic nephropathy in this study was not different from that in major Caucasian or European studies. The risk factors identified in the present study are similar to those reported in the literature. Implementing effective interventions to improve management of these risk factors may lower the risk of development of diabetic nephropathy. |
本系統中英文摘要資訊取自各篇刊載內容。