| Objective To analyze the related factors of urinary albumin to creatinine ratio in hospitalized patients with type 2 diabetes in order to achieve better prevention and treatment.Methods To collect clinical data of 517 hospitalized patients with type 2 diabetes undergoing detection of UACR in department of endocrinology,anhui provincial hospital affiliated to anhui medical university from January 2013 to December 2013.According to the urinary albumin to creatinine rate(UACR), T2 DM cases were divided into normal albuminuria(NAU) group and microalbuminuria(MAU) group and macroalbuminuria(CAU) group.The clinical data of the three groups were compared and the risk factors of DN were analyzed.Gender,age,course of disease,blood pressure,Hb A1 c,Blood lipid(HDL,LDL,TG and TC),BMI,SUA,Scr,ABI,Whether meger hypertension,Coronary Heart Disease,diabetic retinopathy and smoking history were recorded in all the patients.Results 1 Gender and urinary albumin to creatinine ratio The percentages of UACR≥30mg/g C-r of this cohort containing 0517 hospitalized patients were 43.3%.The percentages of albuminuria in male and female were 39.5%,48.6% respectively,P> 0.05,and there was no statistical difference between them.2 Blood pressure and urinary albumin to creatinine ratio Compared with normal albuminuria(NAU)group, The incidence of hypertension increased significantly in microalbuminuria group(MAU) and macroalbuminuria group(CAU),The percentages of hypertension were 42.3%,64.6%,92.4% respectively, P<0.05,and there was statistical difference among them.3 Diabetic retinopathy(DR) and urinary albumin to creatinine ratio Compared with NAU group, The incidence of diabetic retinopathy increased significantly in MAU group and CAU group,The percentages of DR were 19.4%,27.8%,65.2% respectively, P<0.05, and there was statistical difference among them.4 Lower extremity and urinary albumin to creatinine ratio The incidence of lower extremity vascular(ABI<0.9) in NAU group, MAU group and CAU group were 2.0%,1.9%,6.0% respectively, P>0.05,and there was no statistical difference among them.5 Coronary Heart Disease and urinary albumin to creatinine ratio Compared with NAU group, the incidences of Coronary Heart Disease(CHD)increased significantly in MAU group and CAU group,The percentages of CHD were12.6%,21.5%,36.4% respectively, P<0.05,and there was statistical difference among them.6 Serum uric acid and urinary albumin to creatinine ratio Compared with NAU group, The levels of serum uric acid increased significantly in MAU group and CAU group,They were 297±90mmol/l, 304±120mmol/l, 396±108mmol/l respectively, P<0.05,and there was statistical difference among them.7 Smoking and urinary albumin to creatinine ratio Compared with Non-smokers,The incidence of albuminuria increased significantly in male smokers,They were36.9%,63.6% respectively, P<0.05,and there was statistical difference between them.8 Blood lipid and urinary albumin to creatinine ratio Compared with NAU group, The blood Total cholesterol(TC),High-density lipoprotein(HDL) and Low-density lipoprotein(LDL) increased significantly,P<0.05, Serum.Triglycerides(TG) was no statistical difference among them, P>0.05.9 Multiple factors analysis Diabetes duration,LDL,BMI,SBP,SUA,DR and smoking were independent risk factors for UACR according to Logistic regression analysis. Diabetes duration(OR:1.045;95%CI:1.014~1.078;P<0.05),LDL(OR:1.115;95%CI:1.023~1.215;P<0.05),BMI(OR:0.935;95%CI:0.877~0.997;P<0.05),SBP(OR:1.039;95%CI:1.024~1.054;P<0.05),SUA(OR:1.003;95%CI:1.001~1.005;P<0.05),DR(OR:2.017;95%CI:1.287~3.161;P<0.05),smoking(OR:0.946;95%CI:0.886~1.008;P<0.05).Conclusions The occurrence of diabetic nephropathy in patients with type 2 diabetes is associated with coronary heart disease and diabetic retinopathy, hypertension, obesity, high blood uric acid, and smoking are risk factors of proteinuria in diabetic patients. |
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