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在美国,慢性脏病的患病率正在下降. 患有糖尿病的成年人,1999-2018年
Jennifer L Bragg-Gresham1, Yiting Li1, Julie Wright Nunes1
1Department of Internal Medicine - Nephrology, University of Michigan, Ann Arbor, Michigan.
AJPM focus
|February 9, 2026
概括
美国糖尿病成年人的慢性病患病率在过去20年里有所下降,主要是由于白尿减少. 生活方式和医疗管理的改善可能解释了这一趋势.
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:
- 慢性病 (CKD) 是糖尿病的一个重要并发症.
- 了解糖尿病人群中CKD流行趋势对于卫生政策至关重要.
- 最近的数据表明,在美国糖尿病患者中,CKD的潜在减少.
研究的目的:
- 调查1999年至2018年美国糖尿病成年人慢性病患病率的趋势.
- 确定导致随着时间的推移观察到的CKD患病率变化的因素.
主要方法:
- 分析了来自国家健康和营养检查调查 (1999-2018) 的7320名糖尿病成年人的数据.
- 根据估计的淋巴膜过率<60毫升/分钟/1.73米2或专与肌素的比率≥30毫克/克来定义CKD.
- 使用加权后勤回归模型来评估CKD患病率的变化,并根据人口统计,并发病,药物和生活方式因素进行调整.
主要成果:
- 糖尿病患者中的CKD患病率在20年内从40.5%降至35.4% (p=0.02).
- 观察到白色素尿显著下降 (每4年~7%).
- 在对葡萄糖,血压,药物和健康行为进行调整后,下降趋势在统计学上变得无意义,表明这些因素的潜在作用.
结论:
- 在美国,患有糖尿病的成年人中,慢性病的患病率在过去二十年里稳步下降.
- 减少白蛋白尿和改善医疗管理和生活方式行为可能有助于这种下降.
- 对特定干预措施和生活方式修改的影响进行进一步研究是有必要的.
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