A community-based survey on risk factors of type 2 diabetic kidney disease in Ningbo, China

doi:10.3785/j.issn.1008-9292.2018.04.09

J Zhejiang Univ (Med Sci)

2018, Vol. 47

Issue (2): 163-168 DOI: 10.3785/j.issn.1008-9292.2018.04.09

A community-based survey on risk factors of type 2 diabetic kidney disease in Ningbo, China

LI Xiaoyong1(

),SHEN Peng1,LIN Hongbo1,YU Zhebin2,CHEN Kun2,*(

),WANG Jianbing2,*(

)

1. Department of Health Education and Chronic Disease Control, Ningbo Yinzhou District Center for Disease Control and Prevention, Ningbo 315040, Zhejiang Province, China
2. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China

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Abstract

Objective: To investigate the prevalence and risk factors of diabetic nephropathy in Ningbo Yinzhou district. Methods: Nephropathy screening was conducted among patients with type 2 diabetes mellitus (T2DM) registered in Ningbo Yinzhou district. Demographic information, clinical examination information, diabetes complications and behavioral risk factors of enrolled patients were collected. Logistic regression model was used to identify possible risk factors for the occurrence of diabetic nephropathy. Results: Among 10 604 T2DM patients included in this study, there were 3744 cases of diabetic nephropathy(35.31%). Univariate analysis showed that gender, age, education level, diabetes duration, glycemic control, hypertension, stroke, smoking and waist circumference were associated with diabetic nephropathy (P < 0.05 or P < 0.01). Multivariate logistic regression analysis showed that male, elders, long diabetes duration, hypertension and smoking were independent risk factors of diabetic nephropathy (P < 0.05 or P < 0.01). Conclusions: Diabetic nephropathy is of high prevalence in T2DM patients. Male patients, elders, and those with long diabetes duration, hypertension and smoking habits are more likely to have diabetic nephropathy.

Key words： Diabetes mellitus, type 2/complications Diabetic nephropathies/etiology Risk factors Logistic models Odds ratio Blood pressure Smoking

Received: 27 October 2017 Published: 24 July 2018

CLC:	R587.2
	R195.4

Corresponding Authors: CHEN Kun,WANG Jianbing E-mail: 40642702@qq.com;ck@zju.edu.cn;wangjianbing@zju.edu.cn

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Cite this article:

LI Xiaoyong,SHEN Peng,LIN Hongbo,YU Zhebin,CHEN Kun,WANG Jianbing. A community-based survey on risk factors of type 2 diabetic kidney disease in Ningbo, China. J Zhejiang Univ (Med Sci), 2018, 47(2): 163-168.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2018.04.09 OR http://www.zjujournals.com/med/Y2018/V47/I2/163

宁波社区2型糖尿病患者发生糖尿病肾病危险因素调查

目的: 调查宁波市鄞州区2型糖尿病患者糖尿病肾病的发生率，并分析2型糖尿病患者发生糖尿病肾病的危险因素。方法: 收集浙江省宁波市鄞州区所有在册管理且开展过糖尿病肾病筛查的2型糖尿病患者的人口学、临床检测信息、糖尿病合并症和行为危险因素等信息，利用logistic回归分析筛选糖尿病肾病发生的危险因素。结果: 本研究共纳入糖尿病患者10 604例，其中发生糖尿病肾病3744例（35.31%）。单因素分析结果显示，糖尿病肾病发生的风险可能与患者的性别、年龄、文化程度、糖尿病病程、血糖控制情况、是否合并高血压、是否合并脑卒中、是否吸烟和腰围等因素相关（P < 0.05或P < 0.01）。多因素logistic回归分析结果显示，男性、高龄、糖尿病病程长、合并高血压、吸烟等因素可能是糖尿病肾病发生的危险因素（P < 0.05或P < 0.01）。结论: 宁波市鄞州区2型糖尿病患者糖尿病肾病的发生率较高。男性、高龄、吸烟、糖尿病病程长、合并高血压可能会增加糖尿病患者发生糖尿病肾病的风险。

关键词： 糖尿病, 2型/并发症, 糖尿病肾病/病因学, 危险因素, logistic模型, 比值比, 血压, 吸烟

影响因素		糖尿病肾病[n(%)]		P值	OR值(95% CI)
影响因素		是	否	P值	OR值(95% CI)
“—”无相关数据；OR:比值比.^*以患者检测尿微量白蛋白和肌酐时的空腹血糖值判断；^#调整了年龄、性别、糖尿病病程；^△腰围正常指男性腰围在90 cm以下或女性腰围在85 cm以下.
性别	男	1445(38.6)	2890(42.1)	—	1.000
	女	2299(61.4)	3970(57.9)	＜0.01	0.863(0.796~0.937)
年龄段	≤40岁	24(0.6)	52(0.8)	—	1.000
	＞40~50岁	136(3.6)	285(4.2)	＞0.10	1.034(0.612~1.748)
	＞50~60岁	526(14.0)	1261(18.4)	＞0.10	0.904(0.551~1.482)
	＞60~70岁	1425(38.1)	3154(46.0)	＞0.10	0.979(0.601~1.594)
	＞70岁	1633(43.6)	2108(30.7)	＜0.05	1.678(1.030~2.734)
文化程度	小学以下	884(23.6)	1316(19.2)	—	1.000
	小学	1913(51.1)	3644(53.1)	＜0.01	0.782(0.706~0.865)
	初中	792(21.2)	1577(23.0)	＜0.01	0.748(0.663~0.843)
	高中及以上	155(4.1)	323(4.7)	＜0.01	0.714(0.579~0.881)
糖尿病病程	≤5年	1182(31.6)	2689(39.2)	—	1.000
	＞5~10年	1721(46.0)	3062(44.7)	＜0.01	1.279(1.168~1.400)
	＞10年	840(22.4)	1105(16.1)	＜0.01	1.729(1.545~1.936)
血糖控制情况^*	较好(＜7.0 mmol/L)	2591(69.9)	4881(71.8)	—	1.000
	较差(≥7.0 mmol/L)	1114(30.1)	1916(28.2)	＜0.10	1.077(0.986~1.178)
合并高血压^#	无	1575(42.1)	3727(54.3)	—	1.000
	有	2169(57.9)	3133(45.7)	＜0.01	1.442(1.325~1.573)
合并脑卒中^#	无	3721(99.4)	6838(99.7)	—	1.000
	有	23(0.6)	22(0.3)	＜0.10	1.612(0.891~2.913)
吸烟^#	否	3106(33.7)	6113(66.3)	—	1.000
	是	638(46.1)	747(53.9)	＜0.01	1.752(1.501~1.965)
饮酒^#	否	513(36.1)	6860(63.9)	—	1.000
	是	3231(35.2)	5953(64.8)	＞0.10	1.030(0.920~1.160)
体质指数^#(kg/m²)	低体质量(＜18.5)	29(41.4)	41(58.6)	＞0.10	1.310(0.800~2.120)
	正常(18.5~＜24.0)	1682(34.8)	3145(65.2)	—	1.000
	超重(24.0~＜28.0)	1702(35.9)	3037(64.1)	＞0.10	1.050(0.960~1.140)
	肥胖(≥28.0)	331(43.3)	633(65.7)	＞0.10	0.980(0.840~1.130)
腰围^#△	正常	2517(34.6)	4765(65.4)	—	1.000
	超标	1227(35.8)	1963(64.2)	＜0.01	1.142(1.045~1.257)
每周运动时间^#(min)	0	737(35.4)	1343(64.6)	—	1.000
	＞0~＜30	1969(35.4)	3597(64.6)	＞0.10	1.001(0.895~1.102)
	30~＜60	592(34.8)	1110(65.2)	＞0.10	1.005(0.860~1.167)
	≥60	385(35.3)	705(64.7)	＞0.10	0.995(0.854~1.160)

Tab 1 Univariate logistic regression analysis of risk factors for type 2 diabetic kidney

Tab 2 Multivariate logistic regression analysis of risk factors of type 2 diabetic kidney


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