RESUMEN
OBJECTIVE: To study the population receiving care to find the prevalence of diabetic Nephropathy (DNP) and its association with possible risk factors in type 2 Diabetes Mellitus. DESIGN: A descriptive crossover study. SETTING: An urban health district with an aged and socio-economically depressed population. PATIENTS: Randomised sampling among the health district's registered diabetics (n = 198). MEASUREMENTS AND MAIN RESULTS: Among other parameters, the values of Proteinuria and Microalbuminuria in 24 hour's urine and of serum Creatinine were analysed. On the basis of these values the four stages of DNP were established: I) Normality, II) Microalbuminuria, III) Proteinuria, IV) Renal failure. The prevalences recorded were 33.8%, 51%, 11.1% and 4%, respectively. Also studied was the value of Microalbuminuria measured at random by reactive strips dipped in urine, which displayed 78% sensitivity and 68% specificity. The most notable of the DNP risk factors were how long the DM had evolved (p = 0.005). Age (p = 0.02), the value of the glucosilated haemoglobin (p = 0.03) and of the triglycerides (p = 0.03) were also related factors. On analysing the association of DNP with other chronic complications of DM, a statistical relationship to the presence of Retinopathy (p < 0.001) and peripheric Vasculopathy (p < 0.001) was observed. CONCLUSIONS: The presence of some stage of DNP among the type 2 DM population is very common. Only 33.8% of the sample was normal regarding the urinary excretion of proteins. Microalbuminuria quantified at random with reactive strips has low specificity. The highest risk factor for DNP is the length of the DM's evolution, with age and metabolic control of the disease also being important.
Asunto(s)
Albuminuria/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Nefropatías Diabéticas/epidemiología , Anciano , Estudios Transversales , Nefropatías Diabéticas/complicaciones , Femenino , Humanos , Masculino , PrevalenciaRESUMEN
OBJECTIVE: To study the prevalence of clinical forms of diabetic macroangiopathy (DM) and its risk factors. DESIGN: A descriptive crossover study. SETTING: An elderly and socio-economically very depressed population in Raval Sud Health District (HD), Barcelona. PATIENTS AND OTHER PARTICIPANTS: Random sampling of type II diabetes patients (n = 387) registered in the HD (6.6% prevalence). MEASUREMENTS AND MAIN RESULTS: Each patient was examined for the presence of diagnostic criteria of peripheric, cerebral or coronary vasculopathy (VP); as well as for the possible risk factors (age, gender, years of the DM's evolution, tobacco, hypertension, obesity, glycosilated haemoglobin and dyslipemia). Prevalences obtained were: peripheric VP = 24.5%, cerebral VP = 9.5%, coronary VP = 18.1%. 30.5% of the diabetics had some form of macroangiopathy. The main risk factors for all the clinical forms (p < 0.001) were age and the length of evolution of DM, tobacco mainly for peripheric VP (p < 0.001), systolic Hypertension for cerebral VP (p = 0.03) and Hypertriglyceridaemia for peripheric VP (p < 0.01). CONCLUSIONS: Macroangiopathy affects a high percentage (30.5%) of type 2 diabetics. The principal risk factors are those associated with tobacco, hypertension and hypertriglyceridaemia, all of which we can affect and control.