https://scholars.lib.ntu.edu.tw/handle/123456789/496332
標題: | Justifying the high prevalence of microalbuminuria for type 2 diabetic patients in Taiwan with conditional probability approach-a DEMAND II Study | 作者: | Chiang S.-C. Lee J.-K. Chen C.-H. LEE-MING CHUANG Tsan K.-W. Sheu W.H.H. Wu D.-A. Wu T.-J. Lin K.-C. Juang J.-H. CHIH-YUAN WANG Ho L.-T. |
公開日期: | 2011 | 卷: | 74 | 期: | 1 | 起(迄)頁: | 3-10 | 來源出版物: | Journal of the Chinese Medical Association | 摘要: | Background: To examine the prevalence of microalbuminuria (MAU) and chronic kidney disease as well as the correlation between MAU and renal and cardiovascular risks of Type 2 diabetes mellitus (T2DM) patients for public health policy making in Taiwan. Methods: This was a multicenter, hospital-based, randomly selected, and cross-sectional study. T2DM patients aged 18-80 years without a known diagnosis of proteinuria were eligible. MAU was defined as urinary albumin-to-creatinine ratio (ACR) within 30-299. mg/g, and macroalbuminuria as that greater than or equal to 300. mg/g. Two positive out of three urinary screening results were required to make the diagnosis of MAU. The adjusted prevalence of MAU was calculated by conditional probability approach. Results: 51.1% of the analyzed population (n=1,827) were women, with a mean (standard deviation) age of 59.16 years (11.19 years) and mean hemoglobin A1c (HbA1c) of 8.15% (1.83%). Median duration of DM history was 6 years (interquartile range, 3-11 years). The adjusted prevalence of MAU was 26.9%. Overall prevalence of chronic kidney disease Stage 3 or higher (estimated Glomerular filtration rate (eGFR) less than 60/mL/min/1.73m 2) was 13.8%. Only 4.7% of the T2DM patients had serum albumin test recorded and 68.7% with serum creatinine test recorded within the last 6 months. After adjustment for center and gender, the odds ratios for MAU or macroalbuminuria were 1.73 (95% CI, 1.27-2.36) for age greater than or equal to 60 years, 1.54 (1.13-2.10) for abnormal waist circumference, 1.10 (1.02-1.19) for every 1% increase in hemoglobin A1c, 1.91 (1.38-2.65) for higher systolic blood pressure, and 1.92 (1.19-3.07) for abnormal serum creatinine level. Conclusion: This study demonstrates the application of "conditional probability" method to justify the rationale of adopting two positive out of three urinary screening tests for the diagnosis of MAU. An adjusted prevalence rate of MAU as 26.9% is reported. These results may provide a basis for cost-benefit consideration in designing preventive and interventional policies in public health. Furthermore, the awareness and practice of early monitoring of MAU for DM patients should be strengthened. ? 2011. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79551483296&doi=10.1016%2fj.jcma.2011.01.001&partnerID=40&md5=e849b638007c750632f2b434e69fe0a8 https://scholars.lib.ntu.edu.tw/handle/123456789/496332 |
ISSN: | 1726-4901 | DOI: | 10.1016/j.jcma.2011.01.001 | SDG/關鍵字: | albumin; creatinine; hemoglobin; hemoglobin A1c; serum albumin; adult; aged; albumin blood level; article; cardiovascular risk; chronic kidney disease; clinical trial; controlled clinical trial; controlled study; cost benefit analysis; creatinine blood level; cross-sectional study; diabetic patient; estimated glomerulus filtration rate; female; glomerulus filtration rate; health care policy; hemoglobin blood level; human; hypertension; kidney disease; kidney function test; major clinical study; male; microalbuminuria; multicenter study; non insulin dependent diabetes mellitus; prevalence; proteinuria; public health; randomized controlled trial; screening test; systolic blood pressure; Taiwan; urinalysis; urinary albumin to creatinine ratio; waist circumference; Adolescent; Adult; Aged; Aged, 80 and over; Albuminuria; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Female; Humans; Male; Middle Aged; Prevalence; Probability; Risk Factors; Taiwan |
顯示於: | 醫學系 |
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