社区人群微量白蛋白尿相关因素的分析

秦京京; 彭凯月; 王悦; 韩庆烽

doi:10.16766/j.cnki.issn.1674-4152.003207

社区人群微量白蛋白尿相关因素的分析

doi: 10.16766/j.cnki.issn.1674-4152.003207

1.
北京大学第三医院全科医学科, 北京 100191
2.
北京大学第三医院肾内科

基金项目:

国家自然科学基金项目 82070736

详细信息

通讯作者:
韩庆烽，E-mail: hanqingfeng@sina.com

中图分类号: R446 R589
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-05
- 网络出版日期: 2023-11-23

Analysis of factors related to microalbuminuria in community populations

1.
Department of General Medicine, Peking University Third Hospital, Beijing 100191, China

摘要

摘要: 目的分析社区人群中微量白蛋白尿的相关影响因素，为有效地筛查存在肾脏早期损害的居民提供依据。方法选取北京市某社区2021年10月进行定期健康体检的居民为研究对象，分析其体检数据。根据尿白蛋白/肌酐比值划分为微量白蛋白尿组及尿白蛋白正常组，比较2组间临床数据，通过logistic二元回归分析确定与微量白蛋白尿有关的影响因素。结果本研究人群微量白蛋白尿检出率为11.9%(122/1 022)。微量白蛋白尿组及尿白蛋白正常组年龄、代谢综合征、高血压病史、糖尿病病史、腰围、腹型肥胖、葡萄糖、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、白蛋白、尿素、肌酐及肾小球滤过率比较差异均有统计学意义(均P < 0.05)。Logistic回归分析示年龄(OR=1.051，95% CI：1.033~1.070)和代谢综合征(OR=2.254，95% CI：1.425~3.565)与微量白蛋白尿独立相关。在代谢综合征5个组分中，高血糖(OR=2.405，95% CI：1.434~4.035)和高血压(OR=2.082，95% CI：1.189~3.674)与微量白蛋白尿检出相关。结论年龄和代谢综合征与微量白蛋白尿独立相关，且代谢综合征组分中糖尿病和高血压与微量白蛋白尿关系更加密切。
- 微量白蛋白尿 /
- 代谢综合征 /
- 社区慢病管理
Abstract: Objective To analyze the factors influencing microalbuminuria in community populations and provide evidence for effective screening of residents with early kidney injury. Methods All residents who underwent regular health examinations in a community in Beijing in October 2021 were selected as the study population, and their examination data were analyzed. Participants were divided into a microalbuminuria group and a normal urine albumin group based on the urinary albumin-to-creatinine ratio. The clinical data between the two groups were compared, and binary logistic regression analysis was performed to determine the factors associated with microalbuminuria. Results The detection rate of microalbuminuria in the study population was 11.9% (122/1 022). There were statistically significant differences (all P < 0.05) in age, metabolic syndrome, history of hypertension, history of diabetes, waist circumference, abdominal obesity, glucose, glycated hemoglobin, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, albumin, urea, creatinine, and glomerular filtration rate between the microalbuminuria group and the normal urine albumin group. Binary logistic regression analysis showed that age (OR=1.051, 95% CI: 1.033-1.070) and metabolic syndrome (OR=2.254, 95% CI: 1.425-3.565) were independently associated with microalbuminuria. Among the five components of metabolic syndrome, high blood sugar (OR=2.405, 95% CI: 1.434-4.035) and hypertension (OR=2.082, 95% CI: 1.189-3.674) were positively associated with the detection of microalbuminuria. Conclusion Age and metabolic syndrome are independently associated with microalbuminuria, and diabetes and hypertension among the components of metabolic syndrome have a closer relationship with microalbuminuria.
- Microalbuminuria /
- Metabolic syndrome /
- Community chronic disease management

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表 1 微量白蛋白尿组与尿白蛋白正常组人群相关资料比较

Table 1. Comparison of relevant data between microalbuminuria group and normal albuminuria group

组别	例数	年龄(x ±s，岁)	性别[例(%)]		高血压病史[例(%)]	糖尿病病史[例(%)]	高脂血症病史[例(%)]	代谢综合征[例(%)]
组别	例数	年龄(x ±s，岁)	男性	女性	高血压病史[例(%)]	糖尿病病史[例(%)]	高脂血症病史[例(%)]	代谢综合征[例(%)]
MAU组	122	71.92±12.62	75(61.5)	47(38.5)	73(59.8)	37(30.3)	51(41.8)	23(18.9)
非MAU组	900	62.15±14.46	510(56.7)	390(43.3)	295(32.8)	126(14.0)	310(34.4)	93(10.3)
统计量		7.878^a	1.015^b		34.137^b	21.366^b	2.547^b	7.749^b
P值		＜0.001		0.314	＜0.001	＜0.001	0.111	0.005

组别	例数	腰围(x ±s，cm)	腹型肥胖[例(%)]	吸烟史[例(%)]	BMI(x ±s)	葡萄糖(x ±s，mmol/L)	糖化血红蛋白(x ±s，%)	TC(x ±s，mmol/L)
MAU组	122	89.55±10.52	58(47.5)	12(9.8)	25.25±3.84	8.14±3.36	6.70±1.35	4.76±1.05
非MAU组	900	87.16±10.05	295(32.8)	84(9.3)	25.16±3.35	6.65±1.81	6.06±0.94	4.98±1.03
统计量		2.451^a	2.598^b	0.585^b	0.214^a	7.512^a	6.650^a	2.240^a
P值		0.014	0.003	0.444	0.830	＜0.001	＜0.001	0.025

组别	例数	TG(x ±s，mmol/L)	HDL-C(x ±s，mmol/L)	LDL-C(x ±s，mmol/L)	白蛋白(x ±s，g/L)	尿素(x ±s，mmol/L)	肌酐(x ±s，μmol/L)	肾小球滤过率[x ±s，mL/(min·1.73m²)]
MAU组	122	1.74±0.95	1.31±0.32	2.76±0.90	46.73±2.99	5.47±1.96	92.76±29.48	77.09±20.67
非MAU组	900	1.57±0.84	1.38±0.32	2.93±0.89	47.36±2.66	4.82±1.30	82.86±30.19	87.32±18.50
统计量		2.109^a	2.313^a	2.090^a	2.418^a	4.831^a	3.471^a	5.649^a
P值		0.035	0.021	0.037	0.016	＜0.001	0.001	＜0.001
注：^a为t值，^b为χ²值。

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表 2 变量赋值方法

Table 2. Variable assignment methods

变量	赋值方法
性别	女性=0，男性=1
年龄	以实际值赋值
代谢综合征	无代谢综合征=0，有代谢综合征=1
血糖	空腹血糖 < 6.1 mmol/L和无糖尿病病史=0，空腹血糖≥6.1 mmol/L和(或)有糖尿病病史=1
血压	< 130/85 mmHg(1 mmHg=0.133 kPa)和无高血压病史=0，血压≥130/85 mmHg和(或)有高血压病史=1
TG	空腹TG < 1.70 mmol/L=0，空腹TG≥1.70 mmol/L=1
HDL-C	空腹HDL-C≥1.04 mmol/L=0，空腹HDL-C < 1.04 mmol/L=1
腹型肥胖	否=0，是=1

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表 3 微量白蛋白尿影响因素的logistic二元回归分析

Table 3. Logistic binary regression analysis of influencing factors of microalbuminuria

项目	B	SE	Wald χ²	P值	OR值	95% CI
年龄	0.050	0.009	30.073	< 0.001	1.051	1.033~1.070
代谢综合征	0.813	0.234	12.080	0.001	2.254	1.425~3.565

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表 4 微量白蛋白尿与代谢综合征各组分的关系

Table 4. Relationship between microalbuminuria and components of metabolic syndrome

项目	B	SE	Wald χ²	P值	OR值	95% CI
高血糖	0.878	0.264	11.049	0.001	2.405	1.434~4.035
高血压	0.734	0.286	6.585	0.010	2.082	1.189~3.674
高TG	0.087	0.141	0.377	0.539	1.091	0.827~1.439
低HDL-C	-0.043	0.451	0.009	0.925	0.958	0.396~2.321
腹型肥胖	0.501	0.291	2.961	0.085	1.650	0.933~2.920

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