2型糖尿病糖化血红蛋白水平与肾脏微血管病变的关系

Study on the relationship between HbA1c and urine microalbumin.β_2-microglubulin in type 2 diabetes

目的探讨2型糖尿病(DM)糖化血红蛋白(GlycosylatedHemoglobinA1c,GHbA1c)的水平与糖尿病肾脏微血管病变的关系。方法对81例该病患者及33名正常对照者,采用离子交换层析法检测其GHbA1c,RIA法检测尿微量白蛋白(mAlb)和β2-微球蛋白(β2-m)。结果当2型DM患者血GHbA1c正常时,其尿mAlb及β2-m水平与正常人相比无明显差异(P>0.05),但随着血GHbA1c水平的增高,其尿mAlb及β2-m水平随之明显升高(P<0.01),并随血GHbA1c水平的升高呈逐步上升趋势;2型DM患者血GHbA1c水平与尿mAlb及β2-m水平之间呈明显的正相关,不同血GHbA1c水平患者之间的尿mAlb及β2-m水平之间也存在显著性差异(P<0.01)。结论GHbA1c水平与糖尿病肾脏微血管病变密切相关,联合检测GHbA1c、mAlb及β2-m对于糖尿病肾病的早期预防及诊断具有重要意义。

Objective To evaluate tbe relationship between glycated hemoglobin （HbA1c） and nephropathy microvaseular disease in patients with type 2 diabetes.Methods HbAlc was determined by affinity chromatography, 24hour＇ surinemicroalbulin （m-Alb） and urine β2-microglubulin （β2-m） were quantified by radioimmunoassay in 81 patients and 33 controls.Results There were no difference of m- Alb and β2-m between the two groups when HbAlc was within normal range （P〉0.05）. The m-Alb and β2-m elevated significantly according to the elevated HbA1c level （P〈0.01）.There was a positive correlation between HbAlc and m-Alb,β2-m. The significant difference of m-Alb and β2-m among three groups （according to the HbA1c levels, namely〈6.0%, 6.0%-9.0%, 〉9.0%） were also found （P〈0.01）. Conclusion There is a close relationship between HbA1c levels and microvascular nephropathy in diabetic patients. Combined determination of HbA1c,m-Alb and β2-m is very important for prevention and diagnosis of diabetic nephropathy in early stage.