老年2型糖尿病患者尿白蛋白排泄率与高敏C反应蛋白的相关性研究

Relationship between urinary albumin excretion rate and high-sensitive C-reactive protein in elderly patients with type 2 diabetes

目的探讨老年2型糖尿病患者尿白蛋白排泄率(UAER)与高敏C反应蛋白(hs-CRP)的关系。方法将210例老年2型糖尿病患者根据UAER分为正常白蛋白尿(NAU)组、微量白蛋白尿(MAU)组和临床白蛋白尿(CAU)组,以100名健康老年人作为对照(NC)组,检测各组的hs-CRP,并对UAER与有关因素进行单因素线性相关分析。结果NAU、MAU和CAU组的hs-CRP分别为(1.5±0.2)、(3.0±0.9)和(4.4±1.9)mg/L,均明显高于NC组的(0.2±0.1)mg/L(P值均<0.01),MAU和CAU组均明显高于NAU组(P值均<0.01)。进一步线性相关分析表明,老年2型糖尿病患者的UAER水平与稳态模型评估胰岛素抵抗指数(HOMA-IR)、hs-CRP和糖化血红蛋白(HbA_1c)呈正相关(r=0.368、0.376和0.289,P值分别<0.01、0.05)。结论hs-CRP与2型糖尿病及糖尿病肾病的发生明显相关,在2型糖尿病肾病危险因素预测中具有重要意义。

Objective To investigate the relationship between urinary albumin excretion rate（UAER） and high-sensitive C-reactive protein（hs-CRP） in elderly patients with type 2 diabetes. Methods Two hundred and ten patients with type 2 diabetes were divided into 3 groups according to UAER.. nomral albuminuria（NAU）, microalbuminuria（MAU） and clinical albuminuria（CAU） ; 100 healthy subjects were taken as controls. The plasma level of hs-CRP were determined in all patients and the relationship between UAER and other relevant factors was analyzed with linear correlation method. Results The hs-CRP levels in the NAU group, MAU group and CAU group were （1.5 ±0.2） mg/L, （3.0 ± 0. 9） mg/L and （4.4 ± 1. 9） mg/L, respectively; all significantly higher than that of the control group （[0.2 ± 0.1] mg/L, P 〈 0.01 ）. The hs-CRP levels in the MAU group and CAU group were significantly higher than that in NAU group（ P 〈 0.01 ）. Linear correlation showed that UAER level in diabetes patients was positively related to HOMA-IR（ P 〈 0. 01 ）, hs-CRP （ P 〈 0. 01 ） and HbA1c （ P 〈 0. 05 ）. Conclusion Increased hs-CRP level is correlated with the morbidities of type 2 diabetes and diabetic nephropathy （DN）, suggesting that hs-CRP play an important role in prediction of DN. （Shanghai Med J, 2007, 30：834-836）