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Objective: 1. Explore the Tianjin hospital with type 2 diabetes mellitus (T2DM) prevalence and associated risk factors in patients with occult renal disease (ORD). The study of hospitalized patients with T2DM low eGFR risk factors, analysis and comparison of different gender, different age patients with low eGFR risk factors. Method: 1. Selected from January 2001 to December 2008 for the first time in Metabolic Disease Hospital of Tianjin Medical University hospital of diabetes mellitus (DM) patients (1999 WHO diagnostic criteria) of 1186 cases. Exclude the following circumstances: T2DM outside other types of diabetes; combined acute complications; younger than 20 years of age or greater than 80 years old; undergoing dialysis or kidney transplantation history; muscle atrophy or limb absence. The ultimately selected patients with T2DM 1068 cases. Retrospective analysis of 1068 cases of T2DM patients with clinical and laboratory data. The estimated 1068 cases of T2DM patients with glomerular filtration rate (eGFR) by the MDRD formula. According to the the eGFR results of, the 1068 patients divided into eGFR <60ml/min/1.73m2 group (low eGFR group) and the eGFR> 60ml/min/1.73m2 groups (normal eGFR group), clinical and laboratory data for comparative analysis of the two groups analysis of risk factors for T2DM patients with low eGFR. 3.ORD defined as: the eGFR <60ml/min/1.73m2 urinary albumin excretion rate (UAER);, and serum creatinine (Scr) levels were in the normal range. UAER lt; 30mg/24h normal; Scr normal range: male lt; 106umol / L (1.2mg/dl), female lt; 97umol / L (1.1mg/dl). Filter out the risk factors associated with low eGFR group in UAE, and Scr normal patients, calculate the prevalence of T2DM patients ORD analysis T2DM patients ORD. 4 according to gender stratification, then were the men and women grouped by low eGFR and normal eGFR, clinical and laboratory parameters of the two groups were compared. Analysis of the male and female patients with low eGFR risk factors, and to compare the similarities and differences. Will study objects divided according to age (years): lt; 50 ,50-59 group ,60-69 group, ≥ 70 groups, each group was calculated of eGFR <60ml/min/1.73m2 in prevalence. Study lt; 60-year-old and ≥ 60 years of age stratification, and then were each layer are grouped by low eGFR and normal eGFR, compared two groups of clinical and laboratory parameters. Analysis and comparison lt; 60 years of age and risk factors in patients with low eGFR ≥ 60 years. Data analysis using statistical software SPSS11.5. Results: 1. Clinical and laboratory indicators compare: low eGFR compared with normal eGFR group patients were older, more women, longer course, albuminuria, diabetic retinopathy (DR) and high blood pressure patients a higher percentage of SUA, BUN, Scr, TG, SCRP level; the Hemoglobin, HbA1C, UUAE level lower. Low eGFR group BMI, SBP, TC, LDL-C, HOMA-IR were higher, but the difference did not reach statistical significance. 2.T2DM patients with low eGFR factors: eGFR as the dependent variable, logistic regression analysis, the low eGFR related factors include female, age, duration of disease, high blood pressure, high SUA, BUN, TG, VLDL-C and CRP. 3.T2DM patients ORD prevalence rate of 2.24%. Logistic regression analysis showed that the ORD risk factors for women, age, DBP, and smoking history. 4 according to the gender groups, the results are as follows: (1) two sets of the same point: Compared with normal eGFR, low eGFR group of older, longer course, albuminuria and hypertension in patients with a larger proportion of higher levels of SUA, Scr; lower level UUAE. Logistic regression analysis showed that age, duration, high SUA, CRP and hypertension risk factors for male and female patients had low eGFR. (2) male group: men with normal eGFR group, the low eGFR men group SBP, higher CRP levels, smokers account for a smaller proportion; DR) accounted for a higher proportion. The logistic regression analysis showed that male patients with T2DM unique low eGFR risk factors for SBP. (3) female group: compared with normal eGFR women group, of low eGFR women group BUN, TG levels in smokers accounted for a larger proportion of; DBP lower level; DM family history accounted for a lower proportion. The logistic regression analysis showed that female patients with T2DM unique low eGFR risk factors include a history of smoking, TG, TC, LDL-C and VLDL-C. Grouped according to age (years), the results are as follows: lt; 50 ,50-59 group ,60-69 group, the prevalence of ≥ 70 low eGFR were 4.8%, 8.2%, 17.3% and 28.3% . Logistic regression analysis showed: the course of the disease, high SUA, VLDL-C, high blood pressure and CRP lt; 60-year-old group of low eGFR risk factors, women, high blood pressure, LDL-C, low hemoglobin and low UUAE ≥ 60 years of age group eGFR risk factors. Conclusion: 1. Evaluation only UAER and Scr T2DM early kidney damage, and may make about 2.24% of the patients missed, missed more easily seen in women, senior citizens, and a history of smoking and DBP increased mainly in patients with hypertension. 2.T2DM patients with eGFR decline more common in women, senior citizens, long duration and high blood pressure patients, more common in patients with elevated SUA, BUN, TG, VLDL-C and CRP. Early prevention clinical the DN progress, should pay attention to the monitoring or control of the situation. 3 risk factors for eGFR decline with gender differences, the SBP for the male-specific risk factors, smoking history, TG, TC, LDL-C and VLDL-C for the female-specific risk factors. 4. Risk factors cause eGFR decline with age differences, the course of the disease, SUA, VLDL-C, high blood pressure and CRP is a low risk factors for specific age groups, women, high blood pressure, LDL-C, low hemoglobin and low UUAE high age group-specific risk factors.
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