摘要
目的探讨年轻T2DM患者进展为DKD的危险因素。方法选取2018年8月至2019年3月于南京医科大学附属南京医院内分泌科住院的成年T2DM患者514例,分为单纯T2DM组(T2DM,n=367)、年轻DKD组(YDKD,n=29)、老年DKD组(EDKD,n=118),分析临床生化指标及动态血糖监测系统(CGMS)数据。结果与T2DM组比较,YDKD组24 h UAlb、eGFR、WHR、SBP、总蛋白(TP)、白蛋白(ALB)、TC、TG、FPG及FC-P升高,总胆汁酸(TBA)、BUN降低(P<0.05)。与EDKD组比较,YDKD组eGFR、TP、ALB、谷丙转氨酶、TG及FPG水平升高,TBA、BUN及GADAb降低(P<0.05)。CGMS提示YDKD组中、晚餐后BG更高(P<0.05)。多因素Logistic回归分析显示,TG(OR 1.286,95%CI 1.125~1.471)、TBA(OR 0.679,95%CI 0.488~0.944)及ALB(OR 1.200,95%CI 1.046~1.377)是年轻T2DM患者进展为DKD的危险因素(P<0.05)。结论 TG、TBA及ALB是年轻T2DM患者进展为DKD的危险因素,年轻T2DM患者应控制中、晚餐后BG达标。
Objective To investigate risk factors for diabetic kidney disease(DKD)in early-onset T2DM.Methods A total of 514 patients with T2DM were selected as the research subjects.Patients were divided into non-DKD group(T2 DM,n=367),early-onset T2DM with DKD group(YDKD,n=29)and late-onset T2DM with DKD group(EDKD,n=118).Clinical data,history of past illness,laboratory indicators and continuous glucose monitoring system(CGMS)data were collected.Results Compared with the T2DM group,the levels of 24 h UAlb,e GFR,waist-hip ratio,SBP,TP,albumin,TC,TG,FPG,and fasting C peptide were higher in the YDKD group,total bile acid(TBA)and urea nitrogen(BUN)were lower(P<0.05).Compared with the EDKD group,the YDKD group had higher levels of eGFR,TP,ALB,ALT,TC,FPG,lower TBA,BUN and GADAb(P<0.05).CGMS indicated that blood glucose in the YDKD group was higher after lunch and dinner(P<0.05).Multivariate logistic regression analysis showed that TG(OR 1.286,95%CI 1.125~1.471),TBA(OR 0.679,95%CI 0.488~0.944)and ALB(OR 1.200,95%CI 1.046~1.377)were independent risk factors for early-onset DKD(P<0.05).Conclusion TG,TBA and albumin were independent risk factors for early-onset T2DM with DKD.Young T2DM patients should pay attention to controlling postprandial blood glucose after lunch and dinner.
作者
王安宁
胡蕴
钟易
周晓
刘晓梅
毛晓明
WANG Anning;HU Yun;ZHONG Yi;MAO Xiaoming(Department of Endocrinology,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2020年第12期897-902,共6页
Chinese Journal of Diabetes
基金
江苏省自然科学基金青年基金(BK20170136)。
关键词
糖尿病肾脏疾病
糖尿病
2型
甘油三酯
总胆汁酸
血清白蛋白
Diabetic kidney disease
Diabetes mellitus,type 2
Triglycerides
Totle bile acid
Serum albumin
