2型糖尿病微量白蛋白尿与颈动脉内膜中层厚度的关系

The Relationship between Microalbuminuria and Carotid Intima-media Thickness in Type 2 Diabetic Patients

目的探讨2型糖尿病微量白蛋白尿(MAU)与亚临床动脉粥样硬化的关系。方法测定74例2型糖尿病病人的24 h尿白蛋白排泄率(UAER)和颈动脉内膜中层厚度(C-IMT),根据血压、体质量指数(BMI)和年龄分组,取UAER的对数值(lgUAER)与C-IMT进行相关分析。结果MAU者C-IMT为(1.15±0.38)mm,正常白蛋白尿者为(0.89±0.24)mm,MAU者C-IMT明显增厚(P<0.05)。MAU者年龄、BMI、收缩压(SBP)、舒张压(DBP)及脉压差(PP)亦明显增高(P<0.05)。UAER与C-IMT、年龄、BMI、SBP、DBP、PP正相关(相关系数分别是0.28,0.35,0.25,0.36,0.25,0.33,P<0.05)。分别校正了年龄、血压和BMI因素后,仅高血压的2型糖尿病患者UAER与C-IMT相关(相关系数为0.44,P<0.05)。结论2型糖尿病MAU在一定程度上可提示亚临床动脉粥样硬化,但仅是高血压等多种心血管危险因子聚集的反映。

Objective To evaluate the relationship between microalbuminuria and carotid atherosclerosis in type 2 diabetic patients. Methods Urinary albumin excretion rate（UAER） and carotid intima-media thickness（C-IMT） were measured in 74 cases of type 2 diabetic patients. The association between UAER and C-IMT were studied. Results C-IMT in subjects with microalbuminuria and normalbuminura were （1.15±0. 38）mm and （0. 89±0. 24）mm respectively（P〈0. 05）. Subjects with microalbuminuria have higher age, BMI, systolic blood pressure（SBP）, diastolic blood pressure（DBP） and pulse pressure（PP）（P〈0.05）. UAER was positively correlated with C-IMT, age, BMI, SBP, DBP and PP, with the correlation coefficient 0.28, 0.35, 0.25, 0.36, 0.25 and 0.33, respectively（P〈0.05）.After adjustment of age, blood pressure and BMI, UAER was associated with C-IMT only in hypertensive group, with the correlation coefficient 0. 44（P〈0. 05）. Oonclusion Microalbuminuria can imply subclinical atherosclerosis to some extent.