GENDER AND THE CLINICAL USEFULNESS OF THE ALBUMIN - CREATININE RATIO

被引：66

作者：

CONNELL, SJ ^{[1
]}

HOLLIS, S ^{[1
]}

TIESZEN, KL ^{[1
]}

MCMURRAY, JR ^{[1
]}

DORNAN, TL ^{[1
]}

机构：

[1] HOPE HOSP,DEPT ENDOCRINOL,STOTT LANE,SALFORD M6 8HD,LANCS,ENGLAND

来源：

DIABETIC MEDICINE | 1994年 / 11卷 / 01期

关键词：

DIABETES; MICROALBUMINURIA; ALBUMIN-CREATININE RATIO; NEPHROPATHY SCREENING; CREATININE EXCRETION;

D O I：

10.1111/j.1464-5491.1994.tb00226.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

One hundred and eighty-seven diabetic and 105 control subjects collected timed overnight urine samples to measure the inter-individual variation in creatinine excretion rate and its determinants, and to test the relationship between albumin excretion rate (AER) and two 'surrogate measures', the albumin concentration and albumin:creatinine ratio. Creatinine excretion was 55 % higher in men than women (geometric mean 8.9 mumol min-1 (95 % confidence limits 4.7-17.0) compared with 5.7 (3.0-10.9); p < 0.001). Gender .accounted for 31 % of the variation in creatinine excretion and body mass index 1.4 %; neither age nor the diabetic state had a significant effect. The relationships between AER and the two surrogate measures differed between diabetic subjects and controls such that relationships constructed from non-diabetic data would not hold true for diabetes. Likewise, the relationship between AER and albumin:creatinine ratio differed between men and women such that a ratio of 4.0 mg mmol-1 corresponded to a predicted AER of 35 mug min-1 in men and 23 mug min-1 in women. The albumin:creatinine ratio outperformed albumin concentration in terms of sensitivity and specificity and its performance was better in women than men. We conclude that the albumin:creatinine ratio is a better surrogate for AER than albumin concentration. If 'action levels' are to be defined for screening programmes, they should be derived from diabetic and not non-diabetic data and should be different in men and women. We propose a direct rather than screening role for the albumin:creatinine ratio in the management of diabetic nephropathy.

引用

页码：32 / 36

页数：5

共 26 条

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