老年2型糖尿病肾病与胰岛素抵抗及血脂异常的关系分析

Relation of Insulin Resistance and Blood Lipid Abnormity Among Aged Diabetic Nephropathy

目的研究老年2型糖尿病肾病(DN)患者胰岛素抵抗、血脂异常与微量白蛋白尿(mUAE)的关系,以及胰岛素抵抗(IR)、血脂异常在糖尿病肾病发生和发展中的作用。方法对74例无伴肾损害老年2型糖尿病(NIDDM)患者和163例老年DN患者的胰岛素敏感指数(ISI)、24 h微量白蛋白尿(mUAE)、血清脂质进行回顾性分析。结果DN组与NIDDM组相比,总胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白(LDL-C)明显升高,ISI明显降低。并且CHO、TG与mUAE呈正相关,ISI与mUAE呈负相关。Logistic回归分析显示,CHO、TG、IR与DN发生和DN的进展显著关联。结论IR、血脂异常是老年DN发病及病程进展的危险因素。

Objective To investigate the relationship between diabetic nephropathy,insulin resistance and blood lipid abnormity,and the role of insulin resistance and blood lipid abnormity in the development and progression of diabetic nephrop- atby.Methods Insulin-sensitivity index,blood lipid profile and microalbuninuria in 74 aged patients with non-insulin- dependent diabetic mellitus(NIDDM)alone and 163 aged patients complicated with diabetic rephropathy were reviewed retro- spectively.Results CHO,TG and LDL-C were significantly higher in the patients with diabetic nephropathy than those with NIDDM alone,and insulin-sensitivity index was significantly lower.CHO and TG were positively and insulin-sensitivity index was negatively correlated with microalbumincria.Using logistic regression analysis,we found CHO,TG and insulin re- sistance were significantly correlated with the development and progression of diabetic nephropathy.Conclusion Insulin resistance and blood lipid abnormity are the risk factors in development and progression of diabetic nephropathy in the aged population.