背景:2型糖尿病(T2DM)的患病率逐年增加,已成为全球最突出的健康问题之一。2型糖尿病患者易发生感染性疾病,尿路感染也很普遍。尽管对尿路感染(UTI)有全面的了解,目前缺乏关于无症状菌尿(ASB)一级预防策略的研究.
目的:通过Meta分析明确2型糖尿病患者无症状尿路感染的发生率及危险因素,为预防尿路感染提供依据。帮助病人,他们的家人,和照顾者及时发现患者的危险因素并进行干预以降低T2DM患者ASB的发生率。填补了现有研究的空白。
方法:根据PRISMA指南进行Meta分析。
方法:系统搜索11个数据库中关于ASB在T2DM中的文章,检索时间选取自数据库建立至2023年2月5日。文学筛选,质量评价,和荟萃分析由两名研究人员根据纳入和排除标准独立进行,使用Stata17.0进行荟萃分析。
结果:包括14篇文章,包括队列和病例对照研究。纳入4044例T2DM患者的荟萃分析。T2DM患者ASB发生率为23.7%(95%CI(0.183,0.291);P<0.001)。在控制了混杂变量之后,以下危险因素与T2DM患者的ASB相关:年龄(WMD=3.18,95%CI(1.91,4.45),I2=75.5%,P<0.001),女性(OR=1.07,95%CI(1.02,1.12),I2=79.3%,P=0.002),2型糖尿病的持续时间(WMD=2.54,95%CI(1.53,5.43),I2=80.7%,P<0.001),糖化血红蛋白(WMD=0.63,95%CI(0.43,0.84),I2=62.6,%。P<0.001),高血压(OR=1.59,95%CI(1.24,2.04),I2=0%,<0.001),高脂血症(OR=1.66,95%CI(1.27,2.18),I2=0%,P<0.001),神经病变(OR=1.81,95%CI(1.38,2.37),I2=0%,P<0.001),蛋白尿(OR=3.00,95%CI(1.82,4.95),I2=62.7%,P<0.001)。
结论:ASB在T2DM中的总体患病率为23.7%。年龄,女性性别,T2DM的课程,HbA1C,高血压,高脂血症,神经病,蛋白尿是T2DM发生ASB的相关危险因素。这些发现可为预防和管理T2DM中的ASB提供有力的理论依据。
The prevalence of type 2 diabetes mellitus (T2DM) is increasing each year and has become one of the most prominent health concerns worldwide. Patients with T2DM are prone to infectious diseases, and urinary tract infections are also widespread. Despite a comprehensive understanding of urinary tract infection (UTI), there is a lack of research regarding primary prevention strategies for asymptomatic bacteriuria (ASB).
To clarify the incidence and risk factors of asymptomatic urinary tract infection in patients with T2DM by meta-analysis to provide evidence for preventing UTI. Help patients, their families, and caregivers to identify the risk factors of patients in time and intervene to reduce the incidence of ASB in patients with T2DM. Fill in the gaps in existing research.
Meta-analyses were conducted in line with PRISMA guidelines.
Eleven databases were systematically searched for articles about ASB in T2DM, and the retrieval time was selected from the establishment of the database to February 5, 2023. Literature screening, quality evaluation, and meta-analysis were independently performed by two researchers according to the inclusion and exclusion criteria, and a meta-analysis was performed using Stata 17.0.
Fourteen articles were included, including cohort and case-control studies. A meta-analysis of 4044 patients with T2DM was included. The incidence of ASB in patients with T2DM was 23.7%(95% CI (0.183, 0.291); P < 0.001). After controlling for confounding variables, the following risk factors were associated with ASB in patients with T2DM: age (WMD = 3.18, 95% CI (1.91, 4.45), I2 = 75.5%, P < 0.001), female sex (OR = 1.07, 95% CI(1.02, 1.12), I2 = 79.3%, P = 0.002), duration of type 2 diabetes (WMD = 2.54, 95% CI (1.53, 5.43), I2 = 80.7%, P < 0.001), HbA1c (WMD = 0.63, 95% CI (0.43, 0.84), I2 = 62.6,%. P < 0.001), hypertension (OR = 1.59, 95% CI (1.24, 2.04), I2 = 0%, <0.001), hyperlipidemia (OR = 1.66, 95% CI (1.27, 2.18), I2 = 0%, P < 0.001), Neuropathy (OR = 1.81, 95% CI (1.38, 2.37), I2 = 0%, P < 0.001), proteinuria (OR = 3.00, 95% CI (1.82, 4.95), I2 = 62.7%, P < 0.001).
The overall prevalence of ASB in T2DM is 23.7%. Age, female sex, course of T2DM, HbA1C, hypertension, hyperlipidemia, neuropathy, and proteinuria were identified as related risk factors for ASB in T2DM. These findings can provide a robust theoretical basis for preventing and managing ASB in T2DM.