摘要
目的了解糖尿病肾病(DKD)与下肢动脉病变(PAD)的关系及相关因素。方法分析了4 031例2型糖尿病患者的临床资料,将患者分为正常蛋白尿、微量蛋白尿和临床蛋白尿组,并根据踝肱动脉压指数(ABI)分为正常组与异常组,统计各组中尿蛋白和ABI的异常率,采用Logistic回归方法分析PAD与DKD相关性及其影响因素。结果全组患者中尿蛋白异常率26.35%,ABI异常率17.73%;异常组与正常组相比,年龄大,病程长,糖化血红蛋白(HbA1C)高,血压高,脉压差大。正常蛋白尿、微量蛋白尿和临床蛋白尿组的ABI异常率分别为14.55%,21.92%和28.42%;ABI正常和ABI≤0.9、ABI>1.3的患者DKD患病率分别为23.79%,41.43%,30.60%;多因素分析发现,年龄、性别、尿蛋白异常、体质指数(BMI)、立位收缩压、立位舒张压、空腹血糖、总蛋白(TP)、血清白蛋白(AlB)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)是PAD的独立危险因素;年龄、病程、ABI异常、BMI、卧位收缩压、卧位舒张压、餐后血糖、HbA1C、白蛋白、白蛋白/球蛋白(A/G)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),Cr、尿素氮(BUN)是DKD的主要危险因素。结论糖尿病肾病与下肢动脉病变密切相关,可相互促进病情发展。
Objective To evaluate the relationship of diabetic kidney disease and peripheral artery disease （PAD） and their risk factors. Methods The s.tudy was carried out in 4 031 patients with type 2 diabetes. All these patients finished the diabetic complication assessment and were divided into different groups based on the ankle-branchial index （ABI） and albuminuria. The prevalence and related risk factors of PAD and DKD were investigated. Results Prevalence of DKD and abnormal ABI was 26.35% and 17.73% respectively. Prevalence of abnormal ABI was 14.55%, 21.92% and 28.42% in the normal, micro- and clinical albuminuria group. Prevalence of DKD were 23.79%, 41.43% and 30.60% in the patients with ABI normal, 〈0.9 or 〉 1.3. Multiple variables analysis showed that age, sex, albuminuria, BMI, orthostatic systolic blood pressure and diastolic blood pressure, fasting blood glucose, total protein, albumin, total cholesterol, LDL-C and serum creatinine were independent risk factors associated with peripheral artery disease. Age, duration of diabetes, abnormal ABI ,BMI, supine systolic blood pressure and diastolic blood pressure, postprandial blood glucose, HbAlc, albumin, A/G, triglyceride, HDL-C, creatinine and urea nitrogen were risk factors for DKD. Conclusion PAD prevalence increases with higher albuminuria and more severe with the severe kidney disease.
出处
《中国慢性病预防与控制》
CAS
北大核心
2011年第2期162-165,共4页
Chinese Journal of Prevention and Control of Chronic Diseases
关键词
糖尿病
糖尿病肾病
下肢动脉病变
踝肱指数
Diabetes
Diabetic kidney disease
Peripheral arteray disease
Ankle-branchial index
