摘要
目的分析2型糖尿病(T2DM)患者糖尿病肾脏病(DKD)的影响因素及血清胆汁酸谱与DKD的相关性。方法选取2019年1月~2020年12月在我科住院的T2DM患者383例,根据DKD临床诊断标准将其分为DKD组(132例)和无DKD(NDKD)组(251例)。收集两组患者的一般资料(性别、年龄、BMI、血压及糖尿病病程)及实验室检查指标并进行比较。采用Pearson或Spearman相关分析探讨T2DM患者尿白蛋白/肌酐比值(ACR)与临床指标的相关性。采用二元logistic回归分析探讨影响DKD的因素。结果与NDKD组比较,DKD组患者年龄、收缩压(SBP)、糖尿病病程、血尿素氮(BUN)、血肌酐(SCr)、血尿酸(SUA)水平均升高,而总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、熊脱氧胆酸(UDCA)、石胆酸(LCA)水平均降低(P<0.05)。Pearson或Spearman相关分析结果显示,T2DM患者ACR与年龄、糖尿病病程、BUN、SCr、SUA均呈正相关,与TBIL、IBIL、UDCA、LCA均呈负相关(P<0.05)。二元logistic回归分析结果显示,年龄、糖尿病病程、SCr为发生DKD的危险因素,而UDCA、LCA为发生DKD的保护因素(P<0.05)。结论T2DM患者血清胆汁酸谱中UDCA、LCA水平降低与DKD的发生有关,可能为DKD防治的一个新靶点。
Objective To analyze the influencing factors of diabetic kidney disease(DKD)and the correlation between serum bile acid spectrum and DKD in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 383 patients with T2 DM hospitalized in our department from January 2019 to December 2020 were selected and divided into DKD group(132 cases)and no DKD(NDKD)group(251 cases)according to the clinical diagnostic criteria of DKD.The general data(gender,age,BMI,blood pressure and duration of diabetes)and laboratory test indices of patients in two groups were collected and compared.Pearson or Spearman correlation analysis was used to explore the correlation between urinary albumin/creatinine ratio(ACR)and clinical indicators in patients with T2 DM.Binary logistic regression analysis was used to explore the influencing factors of DKD.Results Compared with the NDKD group,patients in the DKD group had higher levels of age,systolic blood pressure(SBP),duration of diabetes,blood urea(BUN),serum creatinine(SCr)and uric acid(SUA),and lower levels of total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),ursus deoxycholic acid(UDCA)and lycholic acid(LCA,P<0.05).Pearson or Spearman correlation analysis showed that ACR in T2 DM patients was positively correlated with age,duration of diabetes,BUN,SCr and SUA,and negatively correlated with TBIL,IBIL,UDCA and LCA(P<0.05).The results of binary logistic regression analysis showed that age,duration of diabetes and SCr were risk factors for the development of DKD,while UDCA and LCA were protective factors for the development of DKD(P<0.05).Conclusion Decreased levels of UDCA and LCA in the serum bile acid spectrum of T2 DM patients are associated with the development of DKD,and may become a new target for DKD prevention and treatment.
作者
徐亚南
温洪华
骆宴施
郭茂君
张少坤
祝群
Xu Yanan;Wen Honghua;Luo Yanshi;Guo Maojun;Zhang Shaokun;ZhuQun(Department of Endocrinology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)
出处
《临床内科杂志》
CAS
2022年第10期679-682,共4页
Journal of Clinical Internal Medicine
关键词
2型糖尿病
糖尿病肾脏病
熊脱氧胆酸
石胆酸
Type 2 diabetes mellitus
Diabetic kidney disease
Ursodeoxycholic acid
Lithocholic acid
