الملخص الإنجليزي
ABSTRACT :
To investigate the prevalence of diabetic albuminuria (microalbuminuria and macroalbuminuria) among patients with type 2 diabetes mellitus (DM) attending the National Center of Diabetes, Endocrinology, and Genetics (NCDEG) among the study group. The second objective of the study is to determine if there is any association between diabetes albuminuria (micro-and macroalbuminuria) and a number of independent variables, including glycemic control, hypertension, duration of diabetes mellitus (DM), serum lipids, body mass index, smoking, age, gender and the presence of retinopathy.
A cross-sectional study was carried out at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG)-Jordan. A total of 869 diabetic patients aged 30 years and above with type 2 diabetes mellitus who attended the clinic at the NCDEG from 1 September 2007 till 10th January 2008 were included.
At least two out of three random morning spot urine samples were collected in a three months period to determine the urinary albumin creatinine ratio (ACR). Microalbuminuria is defined as an ACR of 30-299 mg/g and macroalbuminuria is defined as an ACR ≥300 mg/g according to the definition proposed by the American Diabetes Association (ADA). Sociodemographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS, version 11.5).
Of the 880 patients recruited, 5(0.6%) were excluded due to the presence of urinary tract infections and 6 (0.7%) for the presence of congestive heart failure, leaving 869 patients for evaluation. There were 56.0% male and 44% female. The mean age and duration of diabetes were 57.8 years and 9.5 years respectively. About 62.4% were managed by oral hypoglycemic agents alone, 4.3% by insulin alone, 31.7% were on
combination of oral hypoglycemic agents and insulin, 1.6% were on diet alone. The mean value for HbAlc was 7.71%.
The overall prevalence of albuminuria among participants was found to be 34.6%. Microalbuminuria was found in 29.3%, while macroalbuminuria was found in 5.3%.
Multivariate logistic regression analysis identified HbA1c, SBP, DBP and presence of retinopathy as independent risk factors for microalbuminuria and SBP, male sex and presence of retinopathy as independent risk factors for macroalbuminuria.
Albuminuria is highly prevalent among Jordanians with type 2 diabetes. This calls for early and universal screening of urinary albumin and measures that target tight glycemic, optimal blood pressure control and use of renin-angiotensin system blockade are urgently needed.
