2型糖尿病合并早期糖尿病肾病的相关危险因素分析

Analysis of correlative risk factors of early diabetic nephropathy in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者早期糖尿病肾病(EDN)的相关危险因素,为其防治提供临床依据。方法将171例2型糖尿病患者按尿白蛋白排泄率(UAER)水平分为单纯糖尿病组(SDM,UAER<20μg/min)和早期糖尿病肾病组(EDN,UAER20～200μg/min),观察两组年龄、病程、血压、体重指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹C肽(FCP)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等指标的差异,并进行比较分析。结果EDN组BMI、LDL-C均较SDM组升高,而HDL-C降低,差异有统计学意义(P<0.05),而年龄、病程、FPG、HbA1c、FCP、TG、TC等差异无统计学意义(P>0.05);在50例血脂正常的患者中,SDM组的年龄、病程、TC、LDL-C等指标均低于EDN组(P<0.05);应用χ2检验发现,EDN在血脂正常和异常组中的比例差异有统计学意义(P<0.05);Logistic回归分析显示糖尿病病程、高BMI和高LDL-C与EDN的发病密切相关。结论在2型糖尿病肾病的防治过程中,要注意控制病程、肥胖、血脂等危险因素。

Objective To investigate the risk factors of early diabetic nephropathy in the patients with type 2 diabetes mellitus.Methods Totally 171 patients with type 2 diabetes were enrolled,they were divided into simple diabetes mellitus group （SDM,UAER〈20 μg/min） and early diabetic nephropathy group （EDN,UAER 20～200 μg/min）.and their blood,urine specimens were collected for measuring fasting blood glucose（FPG）,lipid profile,glucosylated hemoglobin（HbA1c）,the fasting C-peptide （FCP）,urinary albumin excretion rate （UAER）.Their disease course,height,body weight （for calculation of BMI）,blood pressure and other clinical data were recorded at the same time.Correlation analysis was conducted.Results The means of BMI （25.43±3.21 vs.24.06±2.95）,LDL（3.09±0.83 vs.2.75±0.89） in EDN group were significantly higher than those in SDM group,Compared with SDM group the mean of HDL（1.11±0.27 vs.1.19±0.27） was lower with significant difference （P〈 0.05） in EDN group .Within the normal range of lipid profile ,the means of age （55.96±13.45 vs.63.64±8.63） ,disease course（6.96±5.82 vs.12.12±6.57）,TC（4.16±0.58 vs.4.44±0.47）,LDL（2.24±0.52 vs.2.60±0.49）in SDM group were lower than those in EDN group.The frequency of EDN with dyslipidemia in T2DM is 57.02%,higher than that in normal range of lipid profile of T2DM （P〈0.01）.Logistic regression analysis showed disease course,higher BMI and LDL may be high risk factors for early diabetic nephropathy.Conclusion The diabetic course,obesity,hypertension and dyslipidemia are the correlated risk factors for early diabetic nephropathy in type 2 diabetes mellitus.