摘要
目的:探讨eGFR≥60 ml/(min·1.73m^(2))的2型糖尿病患者糖化血红蛋白水平与肾小球滤过率的关系。方法:从265例非透析糖尿病患者中选取eGFR≥60 ml/(min·1.73 m^(2))的患者175例;按照糖化血红蛋白(HbA1c)三分位数分为低水平组(HbA1c≤7.7 mmol/L)、中水平组(7.7 mmol/L<HbA1c≤9.6 mmol/L)、高水平组(HbA1c>9.6 mmol/L)。比较各组患者人口学及生化指标等差异。采用单因素线性及多元线性回归分析eGFR≥60 ml/(min·1.73 m^(2))的2型糖尿病患者糖化血红蛋白水平对肾小球滤过率的影响,采用分层分析、交互检验探讨不同人群中糖化血红蛋白水平与肾小球滤过率的关系。结果:HbA1c高水平组的2型糖尿病患者的空腹血糖(FPG)、估算肾小球滤过率(eGFR)高于HbA1c低水平组,差异具有统计学意义(P<0.05)。HbA1c低水平组患者的Scr、BUN高于HbA1c高水平组,差异有统计学意义(P<0.05)。单因素线性回归分析结果显示女性、舒张压、空腹血糖、糖化血红蛋白与eGFR呈正相关,年龄、糖尿病病程、尿总蛋白与eGFR成负相关。多元线性回归分析结果表明校正相关混杂因素后,糖化血红蛋白水平是eGFR≥60 ml/(min·1.73 m^(2))的2型糖尿病患者肾小球滤过率的独立影响因素(β=3.843,95%CI 1.446~6.240,P=0.00204),即糖化血红蛋白每增加1%,eGFR水平增加3.84ml/(min·1.73 m^(2))(P=0.002)。分层分析与交互检验结果显示,当年龄<60岁时,糖化血红蛋白水平对肾小球滤过率的影响更显著(β=5.518,95%CI 2.664~8.372)。结论:eGFR≥60 ml/(min·1.73 m^(2))的2型糖尿病患者糖化血红蛋白水平是肾小球滤过率的独立影响因素,且在年龄小于60岁时糖化血红蛋白水平对肾小球滤过率的影响更显著。
Objective To investigate the relationship between glycated hemoglobin level and glomerular filtration rate in patients with type 2 diabetes with eGFR≥60 ml/(min·1.73 m^(2)).Method 175 patients with eGFR≥60 ml/(min·1.73 m^(2))were selected from^(2)65 non-dialyzed diabetes patients;they were divided into low-level group(HbA1c≤7.7 mmol/L)and intermediate-level group(7.7 mmol/L<HbA1c≤9.6 mmol/L),high level group(HbA1c>9.6 mmol/L),according to the third quartile of glycated hemoglobin(HbA1c).The demographic and biochemical indicators of patients in each group were compared.Single factor linear and multiple linear regression analysis was used to analyze the effect of glycated hemoglobin level on glomerular filtration rate in patients with type 2 diabetes with eGFR≥60 ml/(min·1.73 m^(2)),and stratified analysis and cross-check were used to explore the relationship between relationship of glomerular filtration rate.Results The fasting blood glucose(FPG)and estimated glomerular filtration rate(eGFR)of patients with type 2 diabetes in the high-level HbA1c group were higher than those in the low-level HbA1c group,and the differences were statistically significant(P<0.05).The HbA1c low-level group had higher Scr and BUN than the HbA1c high-level group,and the difference was statistically significant(P<0.05).Univariate linear regression analysis showed that female,diastolic blood pressure,fasting blood glucose,glycated hemoglobin were positively correlated with eGFR,and age,duration of diabetes,and total urine protein were negatively correlated with eGFR.The results of multiple linear regression analysis showed that after adjusting for related confounding factors,glycated hemoglobin level was an independent influencing factor of glomerular filtration rate in patients with type 2 diabetes with eGFR≥60 ml/(min·1.73 m^(2))(β=3.843,95%CI 1.446-6.240,P=0.00204),that was,for every 1%increase in glycated hemoglobin,the eGFR level increases by 3.84 ml/(min·1.73 m^(2)0(P=0.002).The results of stratified analysis and
作者
周文雄
胡豪飞
何永成
ZHOU Wen-xiong;HU Hao-fei;HE Yong-cheng(Clinical College of Shenzhen Second People's Hospital,Guangzhou Medical University,518035,China;Shenzhen Dapeng New District Central Hospital,Shenzhen 518119,China;The Second People's Hospital of shenzhen,shenzhen 518035,China;Shenzhen Heng-sheng Hospital,Shenzhen 518102,China)
出处
《吉林医学》
CAS
2021年第8期1797-1803,共7页
Jilin Medical Journal
基金
深圳市科创委技术开发项目[项目编号:CXZZ20140421155346007]
深圳市科创委技术开发项目[项目编号:CXZZ20150601140615135]
深圳市卫计委重点学科建设能力提升项[项目编号:SZXJ2017031]。
关键词
2型糖尿病
糖化血红蛋白
肾小球滤过率
Type 2 Diabetes mellitus
Glycated hemoglobin
Glomerular filtration rate
