بررسي شيوع و عوامل خطرساز ميكرو آلبومينوري در بيماران مبتلا به ديابت تيپ 2 مراجعه كننده به كلينيك ديابت بيمارستان رازي

Prevalence and Risk Factors of Microalbuminuria in Type 2 Diabetes Mellitus

Objectives: Diabetic nephropathy is one of the most important late complications of diabetes mellitus (DM) which leads to a high rate of morbidity and mortality. In initial stages of diabetic nephropathy, there are some pathologic changes in kidneys and rising of GFR. After several years, microalbuminuria is usually present, which may progress to overt proteinuria and end stage renal disease. This study was designed to assess the prevalence of microalbuminuria in type 2 DM patients visited Razi Diabetes Center of Ahvaz Jundishapur University of Medical Sciences. Material and Methods: A questionnaire included age, sex, time from diagnosis of DM, history of hypertension and hyperlipidemia were filled out for each patient. Laboratory studies include: serum level of BUN, Creatinine, Triglyceride, Cholesterol, 24 h urine collection for measurement of urine creatinine, volume, microalbumin , U/A and U/C were performed for each patient. Results: Ninety out of 199 patients were men and 108 were women (age ranged between 36 to 60 years). 127 patients (63.7%) showed normal urinary microalbumin (less than 30mg/day), 70 patients (35.2%) microalbuminuria (microalbumin excretion between 30-300mg/day) and 2 patients (1.1%) macroalbuminuria (24 h urine microalbumin 300mg/day). 99 patients (43%) had hypertension (BP >_ 140/90 mmHg). 121 patients (61%) had diagnosis of DM for less than five years, 29 (14.5%) between five and ten years and 24 patients (12%) more than 15 years. 41% of patients had familial history of diabetes mellitus and 40% had hyperlipidemia (Triglyceride >250 or Total cholesterol >200 or both). 1-lyperlididemia, higher age group of patients and longer duration of diagnosis of DM had significant effect on the level of microalbuminuria (p< 0.001, <0.001, <0.000 respectively). There were no significant differences between microablumuric and non-microalbuminuric patients, in level of BP and family history of DM. Conclusions: Prevalence of microalbuminuria in the studied group is relatively high (35.2%). Furthermore, hyperlipidemia, older age and duration of DM are risk factors for developing microalbuminuria.