法属圭亚那糖尿病患者慢性肾脏疾病的相关因素

Frontiers in clinical diabetes and healthcare Pub Date : 2023-10-25 eCollection Date: 2023-01-01 DOI:10.3389/fcdhc.2023.1167852
Christopher Sacareau, Mathieu Nacher, Kinan Drak Alsibai, Andre Ntoutoum, Antoine Adenis, Marianne Hounnou, Marion Liebart, Clara Salasar Cardoso, Jean-Markens Aurelus, Magalie Demar, Olivier Casse, Samia Amokrane, Jean-François Carod, Nezha Hafsi, Nadia Sabbah
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引用次数: 0

摘要

导言:由于半数以上的人口生活在贫困线以下,法属圭亚那的社会和卫生状况比法国大陆更为困难。糖尿病的患病率是法国大陆的两倍,终末期肾衰竭的发生率比法国大陆高45%。目的:我们的目的是描述法属圭亚那糖尿病合并慢性肾病患者的概况,并寻找可能的危险因素。方法:我们进行了一项基于CODIAM队列(法国亚马逊地区糖尿病队列)的多中心横断面观察性研究。我们分析了2019年5月至2021年6月期间在卡宴医院、圣罗兰医院和地方卫生中心随访的1287名患者。结果:在我们的队列中,慢性肾脏疾病在平均12年的糖尿病后出现。与法国人口相比,41%的糖尿病患者患有慢性肾脏疾病(即多12%),平均年龄为56岁(即年轻10岁)。这些患者中有48%的人肥胖(即多出7%)。74%的患者不稳定,45%是外国人,但都与慢性肾脏疾病无关,这与卫生系统不普及的国家相反。结论:在法属圭亚那糖尿病患者中筛查慢性肾脏疾病患者仍然是一个真正的挑战。患者比法国其他地区更年轻,更肥胖。在这个队列中,不稳定性和移民与慢性肾脏疾病的存在无关。然而,应特别注意高血压患者和65岁以上的患者,这些患者加上糖尿病本身,是我国糖尿病患者中发生慢性肾脏疾病的两个最明显的危险因素。
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Factors associated with chronic kidney disease in patients with diabetes in French Guiana.

Introduction: With over half of the population living under the poverty threshold, the social and health context in French Guiana is more difficult than in mainland France. The prevalence of diabetes is twice as great and end-stage renal failure is 45% higher than in mainland France.

Objective: Our objective was to describe the profile of diabetic patients with chronic kidney disease in French Guiana and search for possible risk factors.

Method: We conducted a multicenter cross-sectional observational study based on the CODIAM cohort (Cohort of Diabetes in French Amazonia). We analyzed 1,287 patients followed up between May 2019 and June 2021 at Cayenne Hospital, Saint Laurent Hospital, and delocalized health centers.

Results: In our cohort, chronic kidney disease was present after an average of 12 years of diabetes. Compared with the French population, 41% of diabetic patients had chronic kidney disease (i.e., 12% more), and had an average age of 56 years (i.e., 10 years younger). Forty-eight per cent of these patients were obese (i.e., 7% more). Seventy-four per cent of patients were precarious and 45% were foreigners but neither was associated with chronic kidney disease, contrary to countries where the health system is not universal.

Conclusion: Screening of patients with chronic kidney disease among diabetics in French Guiana remains a real challenge. Patients were younger and more obese than in other French territories. In this cohort, precariousness and immigration were not associated with the presence of chronic kidney disease. However, particular attention should be paid to hypertensive patients and those over 65 years of age, which are, with diabetes itself, the two most obvious risk factors for developing chronic kidney disease among diabetic patients in our territory.

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