Exploring The Influence Factors Of Microalbuminuria Among T2dm Patients By The OMAHA Classification System

Objective:According to the OMAHA classification system,exploring the risk factorsof type 2 diabetes mellitus with microalbuminuria from the environmental domain,psychological domain,physiological domain,health-related behaviors domain to general condition.In order to provide the advice for mircroalbuminuria's clinical cure,in the same time provide the screening suggestion for high risk patients.Methods:A cross-sectional descriptive study was conducted from December 2017 to June 2018.According to the OMAHA classification,using the delphi survey technique make the risk factors questionnaire of type 2 diabetes mellitus through reviewing the feature of type 2 diabetes mellitus with microalbuminuria.A questionnaire survey was conducted among the patients who satisfy the inclusion criteria,in the same time a random spot urine sample was collected from each patient.The albuminuria is defined as urine albumin-to-creatinine ratio(ACR)more than 30mg/g,The microalbuminuria is defined as urine albumin-to-creatinine ratio(ACR)between 30 and 300 mg/g,The macroalbuminuria is defined as urine albumin-to-creatinine ratio(ACR)more than 300mg/g.Data analysis was done using SPSS 20.0.Unpaired student's t-test was used to comparing means and Chi-squared test was used for comparison of proportions between groups.A P value of<0.05 was considered statistically significant.Results:Involving 324 patients with type 2 diabetes mellitus,the majority of recruited patients 199(61.40%)were male and female 125(38.60%).The middle age of the patient was 50.77±10.27 years.The albuminuria was found in 68(20.99%)ofstudy participants,among 40(20.10%)in male and 28(22.40%)in female.The microalbuminuria was found in 44(13.58%)of study participants,among24(13.58%)in male and 20(16.00%)in female.Gender was on significantly associated with presence of albumiuria and microalbuminuria.Univariate analysis was used among the hospitalized experience,insulin,hypertension,duration of diabetes,waist hip ratio,waist,systolic blood pressure,diastolic blood pressure,fasting blood glucose levels were high in the microalbuminuria group compare with the normal albuminuria group,and the difference was statistically significant.Recruited patients had 31 health problems according to the OMAHA classification system,including 4 environmental domain problems,6 psychological domain problems,13 physiological domain problems and 8 health-related behaviors domain problems.More than half of health problem were Health care supervision,Substance use,Vision,Income,Physical activity and Neuro-muscle-skeleton function.Multivariate logistic regression analysis indicated that albuminuria was positively associated with fasting blood glucose,hypertension,duration of diabetes and drink,this factors increase the risk of albuminuria range 0.364 to 4.966 respectively.Hypertension,duration of diabetes,fasting blood glucose and drink were the risk factors of microalbuminuria,they increase the risk range 0.251 to 4.233 respectively.Conclusion:1.Risk factor for albuminuria/microalbuminuria were fasting blood glucose,hypertension,duration of diabetes?10years and drink among the type 2 diabetes mellitus outpatients.2.According to the Omaha classification,the outstanding health problems were lacking bloodglucosesupervision,smoking,blurred vision,lowincome,sedentary,numbness of hands and feet.3.The microalbuminuria was positively associated with duration of diabetes,hypertension and fasting blood glucose,additionally most of patients were lacking blood glucose supervision,smoking and sedentary in the daily life.