2型糖尿病及糖尿病肾病危险因素分析

A case-control study of the risk factors of type 2 diabetes mellitus and diabetic nephropathy

目的 研究 2型糖尿病 (DM)及糖尿病肾病 (DN)的易患因素 ,指导临床及早防治。方法 随机选择 2型糖尿病病例 2 0 1例 ,人群对照 110例作病例对照研究。根据尿白蛋白排泄率 (UAER)将 DM患者分为四组互为对照比较。结果 与人群对照组相比 ,DM组在饮酒、喜食甜食、过多摄入动物脂肪、糖尿病家族史、女性病人巨大儿生产史、合并冠心病、高血压、脑血管意外、高脂血症、胰岛素敏感性指标方面有显著差异。DM四组间在年龄、病程、继发糖尿病眼病、糖尿病神经病变、合并高血压、冠心病、脑血管意外、胆囊结石、心电图异常、收缩压、舒张压有显著差异。UAER与糖尿病肾病、眼病、冠心病正相关。结论 饮酒、喜食甜食、过多摄入动物脂肪、糖尿病家族史、女性病人巨大儿生产史、合并冠心病、高血压、脑血管意外、高脂血症、胰岛素抵抗等可能是 2型糖尿病的危险因素。血糖、血脂、血压的不良控制导致糖尿病肾病的进展 ,DN与其他血管并发症或合并症有较好的相关性。

Objective To study the risk factors of type 2 diabetes mellitus and diabetic nephropathy.Methods A case control study based on 201 type 2 diabetes mellitus cases and 110 control cases selected casually was carried out. Type 2 diabetes mellitus patients were divided into four groups according to urine albumium excretion rate (UAER) in order to compare each other.Results Drinking,sweetmeat,excessive fat intake,family history of diabetes mellitus,pregnancy of big baby,coronary heart disease,hypertension,stroke,hyperliponemia,insulin resistin were significantly different between diabetes mellitus and control cases. Age,course of disease,diabetic retinopathy,diabetic neuropathy, hypertension, coronary heart disease, stroke, gall stone,abnormal electrocardiogram,systolic and diastolic blood pressure were significantly different between four diabetic subgroups.Conclusion Drinking,sweetmeat,excessive fat intake.family history of diabetes mellitus,pregnancy of big baby,coronary heart disease, hypertension, stroke,hyperliponemia and insulin resistin might be risk factors of type 2 diabetes mellitus. Poor control of blood sugar, blood pressure result in progressing of DN. DN was closely associated with other vascular complications.Determination of UAER periodical might play an important role in prevention of DN and other vascular complications