Chinese General Practice ›› 2021, Vol. 24 ›› Issue (36): 4653-4660.DOI: 10.12114/j.issn.1007-9572.2021.02.057
Special Issue: 内分泌代谢性疾病最新文章合集
• Monographic Research • Previous Articles Next Articles
Published:
2021-12-20
Online:
2021-12-01
LU Zuowei,LIU Tao,LIU Xiangyang,WANG Qiong,LAI Jingbo,CHEN Yanyan,LI Xiaomiao. Construction and Verification of a Predictive Model for Microalbuminuriain Type 2 Diabetes Mellitus Patients [J]. Chinese General Practice, 2021, 24(36): 4653-4660.
Add to citation manager EndNote|Ris|BibTeX
URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2021.02.057
组别 | 例数 | 性别 | 年龄(岁) | 糖尿病家族史 | 糖尿病病程(年) | 吸烟 | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
男 | 女 | <45 | 45~<60 | ≥60 | 是 | 否 | <5 | 5~<10 | ≥10 | 是 | 否 | ||
开发队列 | 933 | 626(67.1) | 307(32.9) | 182(19.5) | 468(50.2) | 283(30.3) | 459(49.2) | 474(50.8) | 328(35.2) | 237(25.4) | 368(39.4) | 415(44.5) | 518(55.5) |
验证队列 | 378 | 247(65.3) | 131(34.7) | 92(24.3) | 167(44.2) | 119(31.5) | 193(51.1) | 185(48.9) | 138(36.5) | 89(23.5) | 151(39.9) | 171(45.2) | 207(54.8) |
χ2值 | 0.371 | 5.107 | 0.373 | 0.529 | 0.063 | ||||||||
P值 | 0.542 | 0.078 | 0.541 | 0.768 | 0.803 |
Table 1 Comparison of basic demographics and laboratory parameters in development and validation sub-cohorts of type 2 diabetes mellitus patients
组别 | 例数 | 性别 | 年龄(岁) | 糖尿病家族史 | 糖尿病病程(年) | 吸烟 | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
男 | 女 | <45 | 45~<60 | ≥60 | 是 | 否 | <5 | 5~<10 | ≥10 | 是 | 否 | ||
开发队列 | 933 | 626(67.1) | 307(32.9) | 182(19.5) | 468(50.2) | 283(30.3) | 459(49.2) | 474(50.8) | 328(35.2) | 237(25.4) | 368(39.4) | 415(44.5) | 518(55.5) |
验证队列 | 378 | 247(65.3) | 131(34.7) | 92(24.3) | 167(44.2) | 119(31.5) | 193(51.1) | 185(48.9) | 138(36.5) | 89(23.5) | 151(39.9) | 171(45.2) | 207(54.8) |
χ2值 | 0.371 | 5.107 | 0.373 | 0.529 | 0.063 | ||||||||
P值 | 0.542 | 0.078 | 0.541 | 0.768 | 0.803 |
变量 | 赋值 |
---|---|
糖尿病病程 | <5年=1,5~<10年=2,≥1年=3 |
SBP | <140 mm Hg=0,≥140 mm Hg=1 |
FPG | <7.0 mmol/L=0,≥7.0 mmol/L=1 |
TG | <1.7 mmol/L=0,≥1.7 mmol/L=1 |
Scr | ≤106 μmol/L=0,>106 μmol/L=1 |
Cys C | ≤1.09 mg/L=0,>1.09 mg/L=1 |
DR | 否=0,是=1 |
Table 2 Assignment table of influencing factors of microalbuminuria in type 2 diabetes mellitus analyzed using multivariate Logistic regression
变量 | 赋值 |
---|---|
糖尿病病程 | <5年=1,5~<10年=2,≥1年=3 |
SBP | <140 mm Hg=0,≥140 mm Hg=1 |
FPG | <7.0 mmol/L=0,≥7.0 mmol/L=1 |
TG | <1.7 mmol/L=0,≥1.7 mmol/L=1 |
Scr | ≤106 μmol/L=0,>106 μmol/L=1 |
Cys C | ≤1.09 mg/L=0,>1.09 mg/L=1 |
DR | 否=0,是=1 |
预测变量 | β | SE | Wald χ2值 | P值 | 0R | 95%CI | |
---|---|---|---|---|---|---|---|
糖尿病病程(年) | |||||||
<5 | - | - | - | - | 1.000 | - | |
5~<10 | 0.041 | 0.290 | 0.020 | 0.888 | 1.042 | (0.590,1.838) | |
≥10 | 0.382 | 0.260 | 2.156 | 0.412 | 1.465 | (0.880,2.440) | |
SBP(mm Hg) | |||||||
<140 | - | - | - | - | 1.000 | - | |
≥140 | 1.069 | 0.201 | 28.300 | <0.001 | 2.911 | (1.964,4.316) | |
FPG(mmol/L) | |||||||
<7.0 | - | - | - | - | 1.000 | - | |
≥7.0 | 0.646 | 0.236 | 7.476 | 0.006 | 1.909 | (1.201,3.033) | |
TG(mmol/L) | |||||||
<1.7 | - | - | - | 1.000 | - | ||
≥1.7 | 0.438 | 0.202 | 4.709 | 0.030 | 1.550 | (1.043,2.302) | |
Scr(μmol/L) | |||||||
≤106 | - | - | - | - | 1.000 | - | |
>106 | 0.530 | 0.263 | 4.058 | 0.044 | 1.699 | (1.014,2.846) | |
Cys C(mg/L) | |||||||
≤1.09 | - | - | - | - | 1.000 | - | |
>1.09 | 0.883 | 0.280 | 9.957 | 0.002 | 2.417 | (1.397,4.183) | |
DR | |||||||
否 | - | - | - | - | 1.000 | - | |
是 | 0.927 | 0.215 | 18.521 | <0.001 | 2.528 | (1.657,3.856) |
Table 3 Multivariate Logistic regression analysis of influencing factors for microalbuminuria in type 2 diabetes mellitus
预测变量 | β | SE | Wald χ2值 | P值 | 0R | 95%CI | |
---|---|---|---|---|---|---|---|
糖尿病病程(年) | |||||||
<5 | - | - | - | - | 1.000 | - | |
5~<10 | 0.041 | 0.290 | 0.020 | 0.888 | 1.042 | (0.590,1.838) | |
≥10 | 0.382 | 0.260 | 2.156 | 0.412 | 1.465 | (0.880,2.440) | |
SBP(mm Hg) | |||||||
<140 | - | - | - | - | 1.000 | - | |
≥140 | 1.069 | 0.201 | 28.300 | <0.001 | 2.911 | (1.964,4.316) | |
FPG(mmol/L) | |||||||
<7.0 | - | - | - | - | 1.000 | - | |
≥7.0 | 0.646 | 0.236 | 7.476 | 0.006 | 1.909 | (1.201,3.033) | |
TG(mmol/L) | |||||||
<1.7 | - | - | - | 1.000 | - | ||
≥1.7 | 0.438 | 0.202 | 4.709 | 0.030 | 1.550 | (1.043,2.302) | |
Scr(μmol/L) | |||||||
≤106 | - | - | - | - | 1.000 | - | |
>106 | 0.530 | 0.263 | 4.058 | 0.044 | 1.699 | (1.014,2.846) | |
Cys C(mg/L) | |||||||
≤1.09 | - | - | - | - | 1.000 | - | |
>1.09 | 0.883 | 0.280 | 9.957 | 0.002 | 2.417 | (1.397,4.183) | |
DR | |||||||
否 | - | - | - | - | 1.000 | - | |
是 | 0.927 | 0.215 | 18.521 | <0.001 | 2.528 | (1.657,3.856) |
[1] | SAEEDI P, PETERSOHN I, SALPEA P,et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045:results from the International Diabetes Federation Diabetes Atlas,9th edition[J]. Diabetes Res Clin Pract,2019,157:107843.DOI:10.1016/j.diabres.2019.107843. |
[2] | American Diabetes Association.11.microvascular complications and foot care:standards of medical care in diabetes—2020[J]. Diabetes Care,2020,43():S135-151.DOI:10.2337/dc20-S011. |
[3] | ALDEMIR O, TURGUT F, GOKCE C.The association between methylation levels of targeted genes and albuminuria in patients with early diabetic kidney disease[J]. Ren Fail,2017,39(1):597-601.DOI:10.1080/0886022X.2017.1358180. |
[4] | LUK A O Y, HUI E M T, SIN M C,et al. Declining trends of cardiovascular-renal complications and mortality in type 2 diabetes:the Hong Kong diabetes database[J]. Diabetes Care,2017,40(7):928-935.DOI:10.2337/dc16-2354. |
[5] | AFKARIAN M, ZELNICK L R, HALL Y N,et al. Clinical manifestations of kidney disease among US adults with diabetes,1988—2014[J]. JAMA,2016,316(6):602-610.DOI:10.1001/jama.2016.10924. |
[6] | LIU Z H.Nephrology in China[J]. Nat Rev Nephrol,2013,9(9):523-528.DOI:10.1038/nrneph.2013.146. |
[7] | MOGENSEN C E, CHRISTENSEN C K, VITTINGHUS E.The stages in diabetic renal disease.With emphasis on the stage of incipient diabetic nephropathy[J]. Diabetes,1983,32():64-78.DOI:10.2337/diab.32.2.s64. |
[8] | American Diabetes Association.15.diabetes advocacy:standards of medical care in diabetes—2018[J]. Diabetes Care,2018,41():S152-153.DOI:10.2337/dc18-S015. |
[9] | ALBERTI K G, ZIMMET P Z.Definition,diagnosis and classification of diabetes mellitus and its complications.Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med,1998,15(7):539-553.DOI:10.1002/(SICI)1096-9136(199807)15:7<539:AID-DIA668>3.0.CO;2-S. |
[10] | 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志,2021,13(4):315-409.DOI:10.3760/cma.j.cn115791-20210221-00095. |
[11] | ZHANG Z H, ZHANG H Y, KHANAL M K.Development of scoring system for risk stratification in clinical medicine:a step-by-step tutorial[J]. Ann Transl Med,2017,5(21):436.DOI:10.21037/atm.2017.08.22. |
[12] | BALACHANDRAN V P, GONEN M, SMITH J J,et al. Nomograms in oncology:more than meets the eye[J]. Lancet Oncol,2015,16(4):e173-180.DOI:10.1016/S1470-2045(14)71116-7. |
[13] | WANG H J, ZHANG L, LIU Z,et al. Predicting medication nonadherence risk in a Chinese inflammatory rheumatic disease population:development and assessment of a new predictive nomogram[J]. Patient Prefer Adherence,2018,12:1757-1765.DOI:10.2147/PPA.S159293. |
[14] | WEI L, CHAMPMAN S, LI X M,et al. Beliefs about medicines and non-adherence in patients with stroke,diabetes mellitus and rheumatoid arthritis:a cross-sectional study in China[J]. BMJ Open,2017,7(10):e017293.DOI:10.1136/bmjopen-2017-017293. |
[15] | JIANG S M, FANG J Y, YU T,et al. Novel model predicts diabetic nephropathy in type 2 diabetes[J]. Am J Nephrol,2020,51(2):130-138.DOI:10.1159/000505145. |
[16] | ADLER A I, STEVENS R J, MANLEY S E,et al. Development and progression of nephropathy in type 2 diabetes:the United Kingdom Prospective Diabetes Study (UKPDS 64)[J]. Kidney Int,2003,63(1):225-232.DOI:10.1046/j.1523-1755.2003.00712.x. |
[17] | MOGENSEN C E, KEANE W F, BENNETT P H,et al. Prevention of diabetic renal disease with special reference to microalbuminuria[J]. Lancet,1995,346(8982):1080-1084.DOI:10.1016/s0140-6736(95)91747-0. |
[18] | LEEHEY D J, ZHANG J H, EMANUELE N V,et al. BP and renal outcomes in diabetic kidney disease:the veterans affairs nephropathy in diabetes trial[J]. Clin J Am Soc Nephrol,2015,10(12):2159-2169.DOI:10.2215/CJN.02850315. |
[19] | HOLMAN R R, PAUL S K, BETHEL M A,et al. 10-year follow-up of intensive glucose control in type 2 diabetes[J]. N Engl J Med,2008,359(15):1577-1589.DOI:10.1056/NEJMoa0806470. |
[20] | HOLMAN R R, PAUL S K, BETHEL M A,et al. Long-term follow-up after tight control of blood pressure in type 2 diabetes[J]. N Engl J Med,2008,359(15):1565-1576.DOI:10.1056/NEJMoa0806359. |
[21] | HU Y H, SHI R, MO R H,et al. Nomogram for the prediction of diabetic nephropathy risk among patients with type 2 diabetes mellitus based on a questionnaire and biochemical indicators:a retrospective study[J]. Aging (Albany NY),2020,12(11):10317-10336.DOI:10.18632/aging.103259. |
[22] | ISMAIL-BEIGI F, CRAVEN T, BANERJI M A,et al. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes:an analysis of the ACCORD randomised trial[J]. Lancet,2010,376(9739):419-430.DOI:10.1016/S0140-6736(10)60576-4. |
[23] | RUSSO G T, DE COSMO S, VIAZZI F,et al. Plasma triglycerides and HDL-C levels predict the development of diabetic kidney disease in subjects with type 2 diabetes:the AMD annals initiative[J]. Diabetes Care,2016,39(12):2278-2287.DOI:10.2337/dc16-1246. |
[24] | YANG H, YOUNG D, GAO J,et al. Are blood lipids associated with microvascular complications among type 2 diabetes mellitus patients? A cross-sectional study in Shanghai,China[J]. Lipids Health Dis,2019,18(1):18.DOI:10.1186/s12944-019-0970-2. |
[25] | KHAN S H, SOBIA F, NIAZI N K,et al. Metabolic clustering of risk factors:evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance[J]. Diabetol Metab Syndr,2018,10:74.DOI:10.1186/s13098-018-0376-8. |
[26] | CHENG Y Q, SHANG J, LIU D,et al. Development and validation of a predictive model for the progression of diabetic kidney disease to kidney failure[J]. Ren Fail,2020,42(1):550-559.DOI:10.1080/0886022X.2020.1772294. |
[27] | QIU X L, LIU C Y, YE Y Q,et al. The diagnostic value of serum creatinine and cystatin C in evaluating glomerular filtration rate in patients with chronic kidney disease:a systematic literature review and meta-analysis[J]. Oncotarget,2017,8(42):72985-72999.DOI:10.18632/oncotarget.20271. |
[28] | ZENG X F, LU D X, LI J M,et al. Performance of urinary neutrophil gelatinase-associated lipocalin,clusterin,and cystatin C in predicting diabetic kidney disease and diabetic microalbuminuria:a consecutive cohort study[J]. BMC Nephrol,2017,18(1):233.DOI:10.1186/s12882-017-0620-8. |
[29] | PAUL S, ALI A, KATARE R.Molecular complexities underlying the vascular complications of diabetes mellitus -a comprehensive review[J]. J Diabetes Complications,2020,34(8):107613.DOI:10.1016/j.jdiacomp.2020.107613. |
[30] | PEARCE I, SIMÓ R, LÖVESTAM-ADRIAN M,et al. Association between diabetic eye disease and other complications of diabetes:Implications for care.A systematic review[J]. Diabetes Obes Metab,2019,21(3):467-478.DOI:10.1111/dom.13550. |
[1] | WANG Zhen, SHEN Guoqi, LI Yanan, ZHU Yinghua, QIU Hang, ZHENG Di, XU Tongda, LI Wenhua. Development and Validation of a Risk Prediction Model for Contrast-induced Acute Kidney Injury after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction [J]. Chinese General Practice, 2023, 26(29): 3650-3656. |
[2] | LU Zuowei, CAO Hongwei, LIU Tao, ZHANG Nana, CHEN Yanyan, SHI Qinli, LIU Xiangyang, WANG Qiong, LAI Jingbo, LI Xiaomiao. Development and Validation of a Risk Prediction Model for the Progression from Microalbuminuria to Macroalbuminuria in Patients with Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2023, 26(26): 3259-3268. |
[3] | MENG Qizhe, XI Zhi, WANG Ming, WANG Yang, YANG Xiaopeng. Correlation of Blood Glucose Variability with Infarct Burden and Cognitive Impairment in Patients with Type 2 Diabetes Mellitus Complicated with Recent Small Subcortical Infarct [J]. Chinese General Practice, 2023, 26(15): 1885-1891. |
[4] | Zhongyuan HU, Xiuhua ZHANG, Shuaiguang LI, Huarong SHAO, Fei LIU, Bin GUO. Effect of Hyaluronic Acid Oligosaccharides on Diabetic Cutaneous Ulcer Wound Healing by Activating Nrf2 Signaling Pathway [J]. Chinese General Practice, 2022, 25(26): 3281-3289. |
[5] | Ming WANG, Zhi XI, Qizhe MENG, Xiaopeng YANG. Correlation of Glycemic Variability and Time in Range with Early Neurological Deterioration in Patients with Acute Ischemic Stroke and Diabetes [J]. Chinese General Practice, 2022, 25(12): 1418-1423. |
[6] | Daping HE, Qin ZHU, Huirong ZHANG. Awareness of Diabetic Foot, Level and Associated Factors of Foot Self-management Behavior in Wagner Grade 0 Diabetic Foot Patients in the Community [J]. Chinese General Practice, 2022, 25(12): 1460-1463,1469. |
[7] |
JIANG Yuan, JIANG Lingjun, LIU Suzhen, LI Hang.
Prevalence and Associated Factors of Behaviors of Monitoring to Prevent Chronic Diabetic Complications among Type 2 Diabetes Patients Involved in Community-based Management [J]. Chinese General Practice, 2022, 25(01): 70-78. |
[8] | WU Lanxue,WANG Sihu,HUANG Daxiang,HUANG Lijuan,HE Jiang,ZHANG Qiu. Influencing Factors of Painful Diabetic Neuropathy in Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2021, 24(6): 658-662. |
[9] | GUO Maodong,HU Liang,CHEN Yanping,SHI Xin,YE Xiaohua,WANG Qunying,ZHANG Yunyun,DING Jin. A Prediction Nomogram for High-risk Esophageal Varices in Cirrhosis Patients [J]. Chinese General Practice, 2021, 24(30): 3848-3855. |
[10] | WANG Junwei,GUAN Lihua,XING Yuan,PENG Yan,ZHOU Wanying,XUE Huijuan,LIU Yun,LI Lianxi. Management of Type 2 Diabetes and Prediabetes in the Community:a Survey from Shanghai [J]. Chinese General Practice, 2021, 24(27): 3439-3443. |
[11] | WANG Jiuxiang,CHENG Qingfeng,ZHU Shenyin,CHEN Huanhuan,DU Zhipeng,TANG Ziwei. Pilot Clinical Study of Methylene Blue-mediated Photodynamic Antibacterial Chemotherapy to Improve Diabetic Lower Extremity Ulcer Infection [J]. Chinese General Practice, 2021, 24(15): 1903-1908. |
[12] | XING Meiyan,JIANG Tian,XIA Li,ZHANG Yi,XU Juan,LUO Li,HU Honglin,ZHAO Guangbi,LIU Yong,WANG Yikun,XIA Yingwei,ZHANG Qiu. Value of Advanced Glycation End-products in Skin Measured Noninvasively in Community-based Screening of Type 2 Diabetes-related Vascular Complications [J]. Chinese General Practice, 2020, 23(8): 913-919. |
[13] | ZHONG Yuling,FAN Haozhi,ZHANG Ru,WANG Hongliang,ZHANG Wei,TIAN Ting,WANG Qingqing,ZHANG Liuxin,WANG Jie. Associations between HbA1c Glycation Index and Risk of Chronic Complications of Diabetes Mellitus [J]. Chinese General Practice, 2020, 23(3): 276-280. |
[14] | GUO Wenmin,SUN Libin,WANG Dongwen. Recent Advances in Diabetic Cystopathy [J]. Chinese General Practice, 2020, 23(17): 2095-2101. |
[15] | SHAO Jincai,HU Dongming,WAN Gang,LIU Deyuan,CHENG Shuyan,REN Yucui,XIAO Jun,ZHU Yanling,LI Hongfang,GAO Guijuan,SU Liping,MA Lihua,LI Yanfang,ZHANG Wang,HAN Fengrong,WANG Hongjun,et al. Occurrence of Chronic Complications in Community-dwelling Type 2 Diabetic Patients with and without Hypertension in Beijing after 10-year Standardized Management [J]. Chinese General Practice, 2019, 22(24): 2907-2912. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||