摘要
目的按探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血尿酸/高密度脂蛋白胆固醇(serum uric acid/high-density lipoprotein cholesterol ratio,URH)与糖尿病肾病(diabetic kidney disease,DKD)的相关性。方法根据尿白蛋白肌酐比值水平,将171例T2DM患者分为单纯T2DM组(A1组)微量白蛋白尿组(A2组)和大量白蛋白尿组(A3组),对其一般资料、糖化血红蛋白(glycosylated hemoglobinA1,HbAlc)、生化等指标进行比较,并计算URH。结果A1组收缩压、舒张压、血尿酸(serum uricacid,SUA)、甘油三酯(triglyceride,TG)、URH低于其他两组[(129.70±15.78)vs(141.65±16.04)vs(147.31±17.01)mmHg、(78.90±10.71)vs(83.79±10.67)vs(84.61±12.19)mmHg、291.5(253.75,351.25)vs 346(280,409)vs 344.5(274.75,425.75)μmol/L、26.12(19.71,32.96)vs33.45(26.55,42.2)vs33.45(26.55,42.2)](P<0.05),高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)高于其他两组[1.19(1.02,1.29)vs 1.02(0.87,1.21)vs 1.07(0.93,1.25)mmol/L](P<0.05);A3组病程、血肌酐(serumcreatinine,SCr)高于其他两组[10.5(7.25,15)vs8.5(4,12)vs8(3,11)年;82.5(70.57,101.75)vs66(52.75,73.75)vs64(51,84)μmol/L](P<0.05),肾小球滤过率(glo merular filtration rate,eGFR)低于其他两组[91.63(67.09,112.21)vs116.7(96.6,142.53)vs109.85(85.64,152.39)ml·min.1.73m^(2)](P<0.05)。性别、吸烟史、饮酒史、年龄、体质量指数(bodymassindex,BMI)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-densitylipoprotein,LDL-C)、血尿素氮(serum urea nitrogen,BUN)、空腹血糖(fastingbloodglucose,FBG)、HbAlc各组间差异均无统计学意义(P>0.05)。相关分析显示病程、收缩压、舒张压、TG、SUA、URH与尿白蛋白/肌酐比值(UACR)呈正相关,HDL-C与UACR呈负相关(P<0.05)。Logistic回归分析示病程是大量蛋白尿的危险因素,收缩压、URH为微量蛋白尿及大量蛋白尿的危险因素。ROC曲线示URH的AUC值最高,准确率为69.3%。结论URH与DKD发生密切相关,是DKD的危险因素,通过对T2DM�
Objective To investigate the correlation between serum uric acid/high density lipoprotein cho-lesterol(URH)and diabetic nephropathy in patients with type 2 diabetes mellitus(T2DM).Methods According to urinary albumin creatinine ratio,171 patients with T2DM were divided into simple T2DM group(group A1),mi-croalbuminuria group(group A2)and macroalbuminuria group(group A3).The general data,HbAlc,biochemi-cal indices were compared,and URH was calculated.Results The systolic blood pressure,diastolic blood pres-sure,SUA,TG and URH of A1 group were lower than those of the other two groups[(129.7±15.78)vs(141.65±16.04)vs(147.31±17.01)mmHg,(78.9±10.71)vs(83.79±10.67)vs(84.61±12.19)mmHg,291.5(253.75,351.25)vs 346(280,409)vs 344.5(274.75,425.75)μmol/L,26.12(19.71,32.96)vs 33.45(26.55,42.2)vs 33.45(26.55,42.2)](P<0.05).HDL-C was higher than those of the other two groups[1.19(1.02,1.29)vs1.02(0.87,1.21)vs 1.07(0.93,1.25)mmol/L](P<0.05),the course of disease and SCr of group A3 were higher than those of the other two groups[10.5(7.25,15)vs 8.5(4,12)vs 8(3,11)years;82.5(70.57,101.75)vs 66(52.75,73.75)vs 64(51,84)μmol/L](P<0.05),and eGFR was lower than those of the other two groups[91.63(67.09,112.21)vs 116.7(96.6,142.53)vs 109.85(85.64,152.39)ml/min/1.73 m^(2)](P<0.05).There were no significant differences in gender,smoking history,drinking history,age,BMI,TC,LDL-C,BUN,FPG or HbAlc among different groups(P>0.05).Correlation analysis showed that the course of disease,systolic blood pressure,diastolic blood pressure,TG,SUA,URH were positively correlated with UACR,while HDL-C was negatively correlated with UACR.Logistic regression analysis showed that course of disease was a risk factor for macroproteinuria,while systolic blood pressure and URH were risk factors for microproteinuria and macroproteinuria.ROC curve showed that the AUC value of URH was the highest,and the accuracy rate was 69.3%.Conclusions URH is closely related to the occurrence of DKD and is a risk factor of DKD.Dynamic monitoring of URH in T2DM patient
作者
王玉婵
何春玲
胡琛亮
Wang Yuchan;He Chunling;Hu Chenliang(Department of Endocrinology,Huangshan People's Hospital,Huangshan 245000,China;Department of Endocrinology,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《中华内分泌外科杂志》
CAS
2023年第4期464-468,共5页
Chinese Journal of Endocrine Surgery
基金
安徽省高等学校人文社会科学研究项目(sk2019A2014)。
关键词
尿酸
高密度脂蛋白胆固醇
2型糖尿病
粗糖尿病肾病
Uric acid
High-density lipoprotein cholesterol
Type 2 diabetes mellitus
Diabetic kidney disease
