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使用风险评估来改善在美国没有糖尿病的成年人中对白病的查
Jennifer L Bragg-Gresham1, Surekha Annadanam2, Brenda Gillespie3
1Department of Internal Medicine, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA. jennb@umich.edu.
Journal of general internal medicine
|November 18, 2024
概括
一个新的风险评分可以识别没有糖尿病的成年人,他们可能患有白蛋白尿症,这是慢性病 (CKD) 的关键指标. 这种工具有助于在风险人群中更早地检测和管理病.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 目前的指导方针建议每年仅对患有糖尿病 (DM) 的人进行白尿查.
- 缺乏指导指南,用于对患有其他重大慢性病 (CKD) 风险因素,如高血压或家族病史的人进行白尿查.
- 这项研究的目的是开发非糖尿病成年人中白蛋白尿的预测风险评分.
研究的目的:
- 开发和验证一个风险评分来预测没有糖尿病的成年人中的白蛋白尿症.
- 为了在更广泛的人群中促进慢性病 (CKD) 的早期检测和管理.
- 为了确定关键的风险因素,在没有糖尿病的情况下与白蛋白尿相关.
主要方法:
- 分析了来自全国健康和营养检查调查 (1999-2020) 的18岁以上的44322名非糖尿病参与者的数据.
- 使用调查加权后勤回归来评估个体特征与白尿 (尿中的白与肌素比率[UACR]≥30 mg/g) 之间的关联.
- 数据集被分为开发和验证集,C统计用于模型合适性评估.
主要成果:
- 在没有糖尿病的美国成年人中,白色素尿的患病率为9.7%.
- 专尿的显著预测因素包括女性性别,非西班牙裔黑人种族,吸烟,低估计的膜过率 (eGFR),高血压,心血管疾病,糖尿病前期,低HDL胆固醇和高尿酸水平.
- 一个风险评分模型实现了0.756 (发育) 和0.752 (验证) 的C统计,5%的概率值捕获了85%的白尿患者.
结论:
- 在没有糖尿病的个体中选白蛋白尿症的风险评分框架可以帮助更早地检测和管理CKD.
- 需要进一步的纵向研究来证实这种风险评分方法的实用性和成本效益.
- 这种方法可能有助于弥合目前对除糖尿病之外的CKD风险因素的查建议的差距.
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