糖尿病肾病筛查:微量试验对所有糖尿病患者有效吗?

International Journal of Chronic Diseases Pub Date : 2016-01-01 Epub Date: 2016-05-18 DOI:10.1155/2016/2910627
Koubaa Afifa, Sriha Belguith Asma, Harzallah Nabil, Bellaleh Ahlem, Sahtout Mounira, Younes Kawthar, Triki Sonia, Hellara Ilhem, Neffati Fadoua, Najjar Fadhel, Soltani Mohamed
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引用次数: 7

摘要

背景。微量白蛋白试验(MT)对2型糖尿病(T2D)患者微量白蛋白尿(MA)的筛查有一定的帮助。我们的目的是确定MA的患病率和描述MT效度。方法。我们对182例家庭医学T2D随访患者进行了研究。两次24小时尿液MA定量检测作为金标准。结果。MA患病率为23%,CI 95%: 16.9-29.1。MT效度敏感性为77%,阴性预测值为88%,Kappa系数为0.2 (p = 0.001)。在血压≥130/80 mmHg、CHT/HDL比值≥3、T2D≥5年以及女性受试者中,阴性预测值分别为91%、89%、95%和91%。男性的ROC曲线下面积为0.81 (p = 0.008),糖尿病病程超过5年的ROC曲线下面积为0.80 (p = 0.001)。MT在100% Sp下的MA值为35 mg/L。结论。在初级卫生保健中,必须加强对T2D中MA的年度筛查,特别是当糖尿病病程超过5年或与其他心血管风险相关时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Screening for Nephropathy in Diabetes Mellitus: Is Micral-Test Valid among All Diabetics?

Background. Using Micral-test (MT) for screening microalbuminuria (MA) among type 2 diabetics (T2D) is helpful. We aimed at determining prevalence of MA and at describing the MT validity. Methods. We studied 182 T2D followed up in family medicine. Two 24-hour urinary quantitative assays of MA had been used as a gold standard. Results. Prevalence of MA was 23%, CI 95%: 16.9-29.1. MT validity was 77% for sensitivity, 88% for negative predictive value, and 0.2 for Kappa coefficient (p = 0.001). Among subjects having a blood pressure ≥130/80 mmHg, having a CHT/HDL ratio ≥ 3, being a T2D for more than 5 years, and being women, negative predictive values were, respectively, 91%, 89%, 95%, and 91%. The area under the ROC curve was 0.81 in men (p = 0.008) and 0.80 when diabetes duration exceeds 5 years (p = 0.001). The MA value at 100% Sp for MT was 35 mg/L. Conclusion. The use of MT in primary healthcare for yearly screening for MA in T2D must be accentuated especially when diabetes duration exceeds 5 years or when associated with other cardiovascular risks.

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审稿时长
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