摘要
目的探讨SUDOSCAN仪评价2型糖尿病(type 2diabetes mellitus,T2DM)患者肾脏病变的可行性与准确性。方法本研究共纳入297例T2DM患者,根据肾小球滤过率(estimated glomerular filtration rate,eGFR)以及尿白蛋白肌酐比(urinary albumin to creatinine ratio,UACR)分为糖尿病肾功能正常组(对照组)和糖尿病肾病(diabetic kidney disease,DKD)组。结果DKD组患者血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)、UACR高于对照组,eGFR低于对照组(P<0.05)。2组间总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)以及高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)差异均无统计学意义(P>0.05)。DKD组双手电化学汗液电导率平均值(hand electrochemical skin conductance,HESC)、双足电化学汗液电导率平均值(foot electrochemical skin conductance,FESC)以及糖尿病肾脏疾病修正指数(SUDOSCAN-modification of diabetic renal disease,SUDOSCAN-MDRD)均低于对照组,差异有统计学意义(P<0.05)。年龄、病期、糖化血红蛋白(hemoglobin A1c,HbA1c)与HESC呈负相关,eGFR与HESC呈正相关(P<0.05)。年龄、病期、收缩压(systolic blood pressure,SBP)、HbA1c与FESC呈负相关,eGFR与FESC呈正相关(P<0.05)。年龄、病期、SBP、BUN与SUDOSCANMDRD呈负相关,与eGFR呈正相关(P<0.05)。以SUDOSCAN-MDRD预测肾脏损伤明显优于其他指标,其预测DKD的最佳切点为57.50uSi,ROC曲线下面积为67.7%,敏感度为60.0%,特异度为75.0%,准确度为68.7%,阳性预测值为63.6%,阴性预测值为72.1%。结论 SUDOSCAN检测指标与肾功能损伤显著相关,可辅助用于T2DM患者DKD的早期风险筛查。
Objective To explore the feasibility and accuracy of SUDOSCAN in screening kidney disease in patients with type 2diabetes mellitus（T2DM）.Methods Two hundred and ninety-seven patients with T2 DM were recruited in our study.The patients were divided into the normal kidney function group（control group）and diabetic kidney disease（DKD）group according to estimated glomerular filtration rate（eGFR）and urinary albumin to creatinine ratio（UACR）.Results Serum creatinine（SCr）,Blood urea nitrogen（BUN）,UACR in DKD group were significantly higher than control group and eGFR was significantly lower than control group（P〈0.05）.There were no statistical differences in total cholesterol（TC）,triglyceride（TG）,lowdensity lipoprotein cholesterol（LDL-C）and high-density lipoprotein cholesterol（HDL-C）between the two groups（P〉0.05）.HESC,FESC and SUDOSCAN-MDRD in DKD group were significantly lower than control group（P〈0.05）.HESC was negatively correlated with age,disease duration and HbA1 c,but was positively correlated with eGFR（P〈0.05）.FESC was negatively correlated with age,disease duration,systolic blood pressure（SBP）and HbA1 c,but was positively correlated with eGFR（P〈0.05）.SUDOSCAN-MDRD was negatively correlated with age,disease duration,SBP and BUN,but was positively correlated with eGFR（P〈0.05）.Predicting kidney disease with SUDOSCAN-MDRD was better than other indicators.The best cut-off value of SUDOSCAN-MDRD was 57.50 uSi.The area under the curve for DKD was67.7%.The sensitivity was 60.0%,the specificity was 75.0%,accuracy was 68.7%,positive predictive value was 63.6% and negative predictive value was 72.1%.Conclusion SUDOSCAN indexes were correlated with kidney damage and may be used for early risk screening for DKD among T2 DM patients.
出处
《河北医科大学学报》
CAS
2016年第5期510-515,共6页
Journal of Hebei Medical University
基金
国家自然科学基金项目(21331001)
国家科技重大专项子课题(2011ZX09307-001-08)
北京市自然科学基金资助项目(7122109)
关键词
糖尿病
2型
糖尿病肾病
肾小球滤过率
diabetes mellitus
type 2
diabetic nephropathies
glomerular filtration rate
