2型糖尿病患者残余胆固醇与尿白蛋白肌酐比值的相关性

Correlation between residual cholesterol and urinary albumin-to-creatinine ratio in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者残余胆固醇(remnant cholesterol,RC)与尿白蛋白肌酐比值(urine albumin-tocreatinine ratio,UACR)的相关性。方法选取2020年3月至2022年5月于丹东市中心医院内分泌科住院的165例2型糖尿病患者作为研究对象,根据UACR水平将其分成正常白蛋白尿组(A组55例,UACR<30 mg/g)、微量白蛋白尿组(B组55例,UACR30~300 mg/g)、大量白蛋白尿组(C组55例,UACR>300 mg/g)。收集研究对象的一般信息、血脂、尿白蛋白和肌酐等,计算RC和UACR,比较各组间指标的差异,对RC与UACR进行相关性分析。2型糖尿病合并糖尿病肾病(diabetic kidney disease,DKD)的影响因素采用多因素logistic回归分析;绘制受试者工作特征曲线并计算曲线下面积(area under the curve,AUC)评估RC的诊断价值。结果C组RC水平显著高于A组、B组,B组RC水平高于A组,差异有统计学意义(P<0.05)。RC与UACR成正相关(r=0.162,P<0.01)。多元logistic回归分析结果显示,糖尿病病程、RC、年龄、收缩压和总胆固醇是DKD的独立危险因素(P<0.05)。RC对诊断2型糖尿病患者发生DKD有一定的价值(AUC=0.74,95%CI 0.66~0.81,P<0.05),进一步将RC与年龄联合分析发现,诊断价值更高(AUC=0.86,95%CI 0.80~0.92)。结论2型糖尿病患者RC水平与UACR相关,RC可能成为预测2型糖尿病患者发生DKD新的标志物。

Objective To determine the correlation between residual cholesterol(RC)and urinary albumin-tocreatinine ratio(UACR)in type 2 diabetes patients.Methods One hundred sixty-five patients with type 2 diabetes who were hospitalized in the Endocrinology Department of Dandong Central Hospital from March 2020 to May 2022 were selected and divided into the following groups based on UACR:normal albuminuria(group A,55 patients,UACR<30 mg/g);micro-albuminuria(group B,55 patients,UACR 30-300 mg/g);and severe albuminuria groups(group C,55 patients,UACR>300 mg/g).General demographic data,and blood lipid,urinary albumin,and creatinine levels of the study subjects were collected,the RC and UACR were calculated,the differences between the groups were compared,and a correlation analysis between the RC and UACR was performed.Multivariate logistic regression analysis was used to analyze the influencing factors among type 2 diabetes patients with diabetic kidney disease.A receive operating characteristic(ROC)curve of the subjects was created and the area under the ROC curve(AUC)was used to evaluate the diagnostic value of the RC.Results The RC of group C was significantly higher than groups A and B,and the RC of group B was higher than group A(P<0.05).The RC was positively correlated with the UACR(r=0.162,P<0.01).Multivariate logistic regression analysis showed that the course of diabetes,RC level,age,systolic blood pressure,and total cholesterol level were shown to be independent risk factors for diabetic kidney disease(P<0.05).Indeed,the RC level had clinical value in the diagnosis of type 2 diabetes patients with diabetic kidney disease(AUC=0.74,95%CI:0.66-0.81,P<0.05),which was further increased by a combined analysis of the RC level and age(AUC=0.86,95%CI:0.80-0.92).Conclusions The RC level in type 2 diabetes patients is related to the UACR.RC may serve as a new marker for predicting diabetic kidney disease in type 2 diabetes patients.