PMID- 21292196
OWN - NLM
STAT- MEDLINE
DCOM- 20110608
LR  - 20220311
IS  - 1728-7731 (Electronic)
IS  - 1726-4901 (Linking)
VI  - 74
IP  - 1
DP  - 2011 Jan
TI  - Justifying the high prevalence of microalbuminuria for type 2 diabetic patients 
      in Taiwan with conditional probability approach--a DEMAND II study.
PG  - 3-10
LID - 10.1016/j.jcma.2011.01.001 [doi]
AB  - BACKGROUND: To examine the prevalence of microalbuminuria (MAU) and chronic 
      kidney disease as well as the correlation between MAU and renal and 
      cardiovascular risks of Type 2 diabetes mellitus (T2DM) patients for public 
      health policy making in Taiwan. METHODS: This was a multicenter, hospital-based, 
      randomly selected, and cross-sectional study. T2DM patients aged 18-80 years 
      without a known diagnosis of proteinuria were eligible. MAU was defined as 
      urinary albumin-to-creatinine ratio (ACR) within 30-299 mg/g, and 
      macroalbuminuria as that greater than or equal to 300 mg/g. Two positive out of 
      three urinary screening results were required to make the diagnosis of MAU. The 
      adjusted prevalence of MAU was calculated by conditional probability approach. 
      RESULTS: 51.1% of the analyzed population (n=1,827) were women, with a mean 
      (standard deviation) age of 59.16 years (11.19 years) and mean hemoglobin A1c 
      (HbA1c) of 8.15% (1.83%). Median duration of DM history was 6 years 
      (interquartile range, 3-11 years). The adjusted prevalence of MAU was 26.9%. 
      Overall prevalence of chronic kidney disease Stage 3 or higher (estimated 
      Glomerular filtration rate (eGFR) less than 60/mL/min/1.73 m(2)) was 13.8%. Only 
      4.7% of the T2DM patients had serum albumin test recorded and 68.7% with serum 
      creatinine test recorded within the last 6 months. After adjustment for center 
      and gender, the odds ratios for MAU or macroalbuminuria were 1.73 (95% CI, 
      1.27-2.36) for age greater than or equal to 60 years, 1.54 (1.13-2.10) for 
      abnormal waist circumference, 1.10 (1.02-1.19) for every 1% increase in 
      hemoglobin A1c, 1.91 (1.38-2.65) for higher systolic blood pressure, and 1.92 
      (1.19-3.07) for abnormal serum creatinine level. CONCLUSION: This study 
      demonstrates the application of "conditional probability" method to justify the 
      rationale of adopting two positive out of three urinary screening tests for the 
      diagnosis of MAU. An adjusted prevalence rate of MAU as 26.9% is reported. These 
      results may provide a basis for cost-benefit consideration in designing 
      preventive and interventional policies in public health. Furthermore, the 
      awareness and practice of early monitoring of MAU for DM patients should be 
      strengthened.
CI  - Copyright (c) 2011. Published by Elsevier B.V.
FAU - Chiang, Shu-Chiung
AU  - Chiang SC
AD  - Information Management Office, Taipei Veterans General Hospital, Taipei, Taiwan, 
      ROC.
FAU - Lee, Jenn-Kuen
AU  - Lee JK
FAU - Chen, Chih-Hung
AU  - Chen CH
FAU - Chuang, Lee-Ming
AU  - Chuang LM
FAU - Tsan, Kun-Wu
AU  - Tsan KW
FAU - Sheu, Wayne Huey-Herng
AU  - Sheu WH
FAU - Wu, Du-An
AU  - Wu DA
FAU - Wu, Ta-Jen
AU  - Wu TJ
FAU - Lin, Kwo-Chuan
AU  - Lin KC
FAU - Juang, Jyuhn-Huarng
AU  - Juang JH
FAU - Wang, Chih-Yuan
AU  - Wang CY
FAU - Ho, Low-Tone
AU  - Ho LT
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - J Chin Med Assoc
JT  - Journal of the Chinese Medical Association : JCMA
JID - 101174817
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Albuminuria/*epidemiology/etiology
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Diabetic Nephropathies/*epidemiology/etiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Probability
MH  - Risk Factors
MH  - Taiwan/epidemiology
EDAT- 2011/02/05 06:00
MHDA- 2011/06/09 06:00
CRDT- 2011/02/05 06:00
PHST- 2009/10/14 00:00 [received]
PHST- 2010/09/02 00:00 [accepted]
PHST- 2011/02/05 06:00 [entrez]
PHST- 2011/02/05 06:00 [pubmed]
PHST- 2011/06/09 06:00 [medline]
AID - S1726-4901(11)00002-5 [pii]
AID - 10.1016/j.jcma.2011.01.001 [doi]
PST - ppublish
SO  - J Chin Med Assoc. 2011 Jan;74(1):3-10. doi: 10.1016/j.jcma.2011.01.001.