摘要
目的探讨血清胆红素对2型糖尿病患者慢性并发症的预测价值.方法选择2018年6月至2019年6月2型糖尿病患者841例,记录患者年龄、糖尿病病程、体重、身高、血清总胆红素(TBIL)、间接胆红素(IBIL)、直接胆红素(DBIL)、血清胱抑素C(Cys-C)、空腹血糖、糖化血红蛋白、血肌酐、血尿酸及尿白蛋白/尿肌酐(ACR)等.计算预估肾小球滤过率(eGFR)、体质量指数.根据眼底检查、神经肌电图等检查筛查糖尿病并发症.分析糖尿病并发症与胆红素的相关性,根据并发症数量分为四组:G0(无并发症);G1(一种并发症);G2(两种并发症);G3(三种并发症);将四组患者与血清胆红素水平进行趋势分析,比较四组患者基本资料及生化指标的差异.结果Spearman分析显示糖尿病视网膜病变、糖尿病周围神经病变及糖尿病肾病分别与TBIL、IBIL、DBIL呈负相关(P<0.01).并显示患者合并糖尿病并发症数量分别与TBIL、IBIL、DBIL存在趋势关系(P<0.01).经方差检验显示四组间血清TBIL、IBIL、DBIL、CysC、eGFR、血肌酐、ACR差异有统计学意义(P<0.01).结论2型糖尿病患者并发症的数量与血清胆红素存在趋势相关.血清胆红素对糖尿病并发症的发生可能具有预测价值.
Objective To explore the predictive value of serum bilirubin on chronic complications in patients with type 2 diabetes.Methods From June 2018 to June 2019,841 patients with type 2 diabetes were enrolled.The age,course,weight,height,total bilirubin(TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL),Cystatin C(Cys-C),fasting blood glucose,glycosylated hemoglobin,creatinine,uric acid and urinary albumin/creatinine(ACR)were recorded.The estimated glomerular filtration rate(eGFR)and body mass index were calculated.According to the fundus examination,neuroelectromyography and other examinations to screen diabetic complications.According to the number of complications,the patients were divided into four groups:GO(no complications);G1(one complication);G2(two complications);G3(three complications);the four groups were analyzed with the trend of serum bilirubin level,and the differences of basic data and biochemical indexes were compared.Results Spearman analysis showed that diabetic retinopathy,diabetic peripheral neuropathy and diabetic nephropathy were negatively correlated with TBIL,IBIL and DBIL respectively(P<0.01).There were trend relationships between the number of diabetic complications and TBIL,IBIL,DBIL(.P<0.01).There were significant differences in serum TBIL,IBIL,DBIL,CysC,eGFR,creatinine and ACR in the four groups(P<0.01).Conclusion The number of complications in patients with type 2 diabetes mellitus are related to the trend of serum bilirubin.Serum bilirubin may have a predictive value for the occurrence of diabetic complications.
出处
《浙江临床医学》
2020年第7期1028-1029,1033,共3页
Zhejiang Clinical Medical Journal
