새로 진단받은 제2형 당뇨병에서 미세알부민뇨와 관련 인자
The prevalence of microalbuminuria and associated factors in newly diagnosed type 2 diabetes mellitus in Korea
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목적 : 당뇨병성 신증의 초기 단계인 미세단백뇨는 현성단백뇨의 발생을 예측할 뿐 아니라 심혈관 질환의 독립적 위험인자로 알려져 있다. 하지만 국내에서는 지역사회 인구집단을 대상으로 한 미세단백뇨의 유병률에 대한 연구는 있었으나 새로 진단받은 제2형 당뇨병 환자에서 미세단백뇨의 유병률에 대해서는 아직까지 연구된 바가 없어 새로 진단받은 제2형 당뇨병 환자에서 미세단백뇨의 유병률을 구하고 이와 관련된 인자를 찾고자 본 연구를 시행하였다. 방법 : 본 연구는 2004년 5월부터 2006년 2월까지 고려대학교 안암병원을 방문해 새로 제2형 당뇨병으로 진단받은 304명의 남녀를 대상으로 미세단백뇨의 유병률을 구하고, 미세단백뇨와 관련된 인자를 찾았다. 결과 : 새로 진단받은 한국인 제2형 당뇨병 환자에서 미세단백뇨의 유병률은 17.1%이며 정상단백뇨는 80.3%, 현성단백뇨는 2.6%를 차지 하였다. 미세단백뇨와 관련성을 보인 인자로는 체질량지수, 공복시 인슐린, 공복시 C-peptide, 중성지방이 있었고, 대사증후군의 구성인자의 수와 유의한 양의 상관관계를 가졌다. 망막병증 유무에 따른 분석 결과 미세단백뇨는 있으나 망막병증을 보이지 않는 군에서 대사증후군과 관련성이 높았다. 결론 : 새로 진단받은 한국인 제2형 당뇨병 환자에서 대사증후군의 구성인자의 수와 미세단백뇨의 양 사이에 관련성을 보여 미세단백뇨가 대사증후군의 한 구성인자임을 추정할 수 있으며 특히 망막병증을 동반하지 않은 제2형 당뇨병 환자에서 미세단백뇨와 대사증후군의 관련성이 높았다.
Abstract
Background : To determine the prevalence and the associated factors of microalbuminuria in Korean subjects with newly diagnosed type 2 diabetes mellitus. Methods : A total of 304 patients with newly diagnosed type 2 diabetes mellitus that visited Anam Hospital, Korea University Medical Center, were studied cross-sectionally for the presence of microalbuminuria and other micro- and macrovascular complications. Microalbuminuria was calculated by the amount of albumin excretion in the urine for 24 hrs (30-299 mg/24hr) or by the albumin creatinine ratio in a spot urine sample (30-299 mg/g creatinine). Subjects were divided into two groups: the normoalbuminuria group and the microalbuminuria group. Results : The prevalence of microalbuminuria, normoalbuminuria and overt proteinuria in patients with newly diagnosed type 2 diabetes mellitus was 17.1%, 80.3% and 2.6%. respectively. Microalbuminuria was significantly correlated with the body mass index (BMI), fasting insulin level, fasting C-peptide level and triglyceride level. The number of metabolic syndrome components was significantly correlated with the amount of microalbuminuria. In patients with microalbuminuria and without retinopathy, the correlation of microalbuminuria and the presence of metabolic syndrome was also significant. Conclusions : The prevalence of microalbuminuria in 304 Korean patients with newly diagnosed type 2 diabetes mellitus was 17.1%, and microalbuminuria had a correlation with the BMI, fasting insulin level, fasting C-peptide level, HOMA level, triglyceride level and the presence of metabolic syndrome.(Korean J Med 73:503-511, 2007)
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