JAMA Intern Med：随机尿白蛋白可用于筛查早期糖尿病肾病

2014-05-13 佚名丁香园

国立台湾大学的Hon-Yen Wu称，随机尿液中的白蛋白浓度和白蛋白/肌酐比值一样，也可用于在糖尿病患者中筛查微量白蛋白尿。 Wu教授在写给路透社健康新闻的邮件中写道，“在我们的研究中，尿白蛋白浓度的优势和实用性纯粹是基于在糖尿病患者中筛查微量白蛋白尿考虑。但是，这个阳性结果仍然需要通过测量计时尿标本或随机尿标本来证实。” 由于微量白蛋白尿是肾功能下降、及心血管疾病发病率和死亡率的独立危险因素

国立台湾大学的Hon-Yen Wu称，随机尿液中的白蛋白浓度和白蛋白/肌酐比值一样，也可用于在糖尿病患者中筛查微量白蛋白尿。

Wu教授在写给路透社健康新闻的邮件中写道，“在我们的研究中，尿白蛋白浓度的优势和实用性纯粹是基于在糖尿病患者中筛查微量白蛋白尿考虑。但是，这个阳性结果仍然需要通过测量计时尿标本或随机尿标本来证实。”

由于微量白蛋白尿是肾功能下降、及心血管疾病发病率和死亡率的独立危险因素，指南推荐在糖尿病患者中筛查微量白蛋白尿。然而，糖尿病患者中筛查微量白蛋白尿的最佳方法仍未确定。

Wu教授及其同事通过回顾14项已发表的研究，来比较随机尿白蛋白浓度（UAC）与白蛋白/肌酐比值（ACR）筛查糖尿病患者中微量白蛋白尿。同时，Wu教授等使用24小时尿标本作为参考标准。

依据Wu教授等于2014年05月05日在线发表在《美国医学会杂志·内科学》上的数据，各项研究间的UAC与ACR敏感性汇总没有显著差异。UAC与ACR筛查微量白蛋白尿的特异性都为88%，而且，两种方法的诊断比值比没有显著差异。

Wu教授总结到，“我们的荟萃分析表明，UAC与ACR在糖尿病患者微量白蛋白尿筛查中都具有较高的敏感性和特异性。尽管UAC的诊断性能没有明显优于ACR，考虑到全球卫生保健资源有限，而糖尿病发病率在不断攀升，微量白蛋白尿大规模人群筛查的费用将是一个重要的问题。”

Wu教授同时也指出，“在以下条件下，应考虑使用24小时尿标本筛查微量白蛋白尿：1.假如需要一个确切的测量值；2.假如门诊患者的依从性良好；3.假如同时需要用24小时尿标本中测量其他生物指标，例如肌酐清除率、儿茶酚胺、尿素氮或电解质。”

原始出处

Wu HY1, Peng YS2, Chiang CK3, Huang JW3, Hung KY3, Wu KD3, Tu YK4, Chien KL5.Diagnostic Performance of Random Urine Samples Using Albumin Concentration vs Ratio of Albumin to Creatinine for Microalbuminuria Screening in Patients With Diabetes Mellitus: A Systematic Review and Meta-analysis.JAMA Intern Med. 2014 May 5

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2015-08-04 sundong

这个是新闻吗

102 0
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2015-02-10 xxxx1049

#尿白蛋白#

41 0
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2014-06-25 匿名用户

这不是糖届老久的观点吗？5年之前

49 0
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2014-05-15 珙桐

#白蛋白#

24 0
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2014-05-15 ms3994565386320060

#Med#

24 0
[GetPortalCommentsPageByObjectIdResponse(id=34386, encodeId=601934386a2, content=这个是新闻吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ykRSkuxjt93yc9tvDWfIQItrwiaKSCps5kyrTyDlwic2FgoCWe88wR3ZiaggKYGueDIp26zVgnbzriaQ/0, createdBy=89d71602869, createdName=sundong, createdTime=Tue Aug 04 19:08:00 CST 2015, time=2015-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2077946, encodeId=a2fc20e794677, content=<a href='/topic/show?id=91104e474b5' target=_blank style='color:#2F92EE;'>#尿白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47474, encryptionId=91104e474b5, topicName=尿白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9dd613, createdName=xxxx1049, createdTime=Tue Feb 10 04:12:00 CST 2015, time=2015-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=10063, encodeId=32311006366, content=这不是糖届老久的观点吗？5年之前, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=, createdTime=Wed Jun 25 21:07:00 CST 2014, time=2014-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304580, encodeId=05ad130458008, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Thu May 15 00:12:00 CST 2014, time=2014-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606182, encodeId=6bc8160618203, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu May 15 00:12:00 CST 2014, time=2014-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9381, encodeId=4a33938165, content=随机微量白蛋白尿，虽然样本内误差可能更大一些，但是临床实用性更高。, beContent=null, objectType=article, channel=null, level=null, likeNumber=160, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.226.57.54, createdTime=Tue May 13 15:27:00 CST 2014, time=2014-05-13, status=1, ipAttribution=)]
2014-05-13 116.226.57.54

随机微量白蛋白尿，虽然样本内误差可能更大一些，但是临床实用性更高。

160 0

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JAMA Intern Med：随机尿白蛋白可用于筛查早期糖尿病肾病

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