2型糖尿病患者糖代谢指标与尿白蛋白肌酐比的相关性研究

Relationship between glucose metabolism and urinary albumin creatinine ratio in type 2 diabetes

关键词:  2型糖尿病  糖代谢异常  尿白蛋白肌酐比

Key words:  [Key words]　glucose metabolism  urinary albumin creatinine ratio  type 2 diabetes

摘要:

[摘要]　目的　通过对社区居民进行横断面研究，分析2型糖尿病（T2DM）患者糖代谢指标与尿白蛋白肌酐比的相关性。　方法　研究对象为参加中华医学会发起的“中国T2DM患者肿瘤发生风险的流行病学研究”大连地区的社区居民，入选研究对象共计10 155例。检测空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）、血脂、尿白蛋白及尿肌酐，根据尿白蛋白肌酐比（UACR）将研究对象分为：正常白蛋白尿组，微量白蛋白尿组及大量白蛋白尿组，分析3组间糖代谢指标的差异，分析上述指标与UACR的相关性。 　结果　（1）不同血糖状态组，其尿白蛋白异常率发生不同，糖尿病组患者其尿白蛋白异常率明显高于非糖尿病组患者，P<0.05。（2）对于糖尿病患者，微量白蛋白尿及大量白蛋白尿组的FPG、2hPG及HbA1c水平均明显高于正常白蛋白尿组；FPG、2hPG及HbA1c水平更高的糖尿病患者，其微量白蛋白尿及大量白蛋白尿发生率也更高，P<0.05。（3）Pearson相关分析显示：FPG、2hPG、HbA1c、总胆固醇水平（TC）、甘油三酯水平（TG）、收缩压（SBP）、舒张压（DBP）、年龄、病程、体质指数（BMI）、腰臀比（WHR）与UACR呈正相关(r值分别为0.259、0.197、0.239、0.077、0.153、0.219、0.114、0.096、0.087、0.114)，高密度脂蛋白胆固醇水平（HDL-C）与UACR呈负相关（r值为-0.071）， P均＜0.05。（4）多元逐步回归显示：FPG、HbA1c、SBP、TG、HDL-C与UACR独立相关。(β值分别为：0.164、0.101、0.200、0.076、-0.069)，P均＜0.05。　结论　T2DM患者糖代谢指标与UACR密切相关，FPG、HbA1c、SBP、TG、HDL-C为UACR的独立危险因素。

Abstract:

[Abstract] Objective　To evaluate the relationship between glucose metabolism and urinary albumin creatinine ratio in type 2 diabetes. 〖WTHZ〗Methods〖WTBZ〗 A total of 10 155 subjects in Dalian area were enrolled in the epidemiological study of tumor risk of Chinese type 2 diabetes mellitus patients. Values of glucose metabolism, including the fasting plasma glucose (FPG), 2 hours blood glucose (2hPG), glycosylated hemoglobin (HbA1c), blood lipid, urinary albumin and creatinine, were measured. According to the urine albumin creatinine ratio (UACR), subjects were divided into three groups including normoalbuminuria group, microalbuminuria group and macroalbuminuria group. Difference among the three groups in glucose metabolic indexes and the relationship between glucose metabolism and UACR were analyzed. 〖WTHZ〗Results〖WTBZ〗 （1） In different glycemic status group, the incidence of abnormal urinary albumin was different. In diabetic group, it was much higher than that in non-diabetes group (P<0.05). （2） As for diabetes, the levels of FPG, 2hPG and HbA1c in microalbuminuria and macroalbuminuria groups were much higher than those of normoalbuminuria group. As the levels of glucose metabolism were higher, the incidence of microalbuminuria and macroalbuminuria increased. （3） Pearson correlation coefficient analysis revealed that FPG, 2hPG, HbA1c, total cholesterol (TC), triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), age, course of disease, body mass index (BMI) and waist-hip ratio (WHR) were positively correlated with UACR (r=0.259, 0.197, 0.239, 0.077, 0.153, 0.219,0.114, 0.096, 0.087, 0.114 respectively); high density lipoprotein cholesterol (HDL-C) and UACR were negatively correlated (r=-0.071). All P values were less than 0.05. （4）Multiple stepwise regression showed that FPG，HbA1c，SBP，TG，HDL-C were risk factors for the UACR β=0.164，0.101，0.200，0.076，-0.069), all P values ＜0.05. 〖WTHZ〗Conclusion　The indexes of glucose metabolism in T2DM diabetes are closely related to the UACR. FPG,HbA1c,SBP,TG and HDL-C are risk factors for the UACR.