2型糖尿病微量白蛋白尿与动脉硬化危险因素关系的研究

Study of the association between microalbuminuria and risk factors for atherosclerosis in type 2 diabetes mellitus

目的研究2型糖尿病(T2DM)微量白蛋白尿(MAU)与致动脉粥样硬化危险因素间的关系。方法回顾分析1995—2009年在卫生部北京医院住院的T2DM患者1004例,按尿白蛋白排泄率(UAER)分为MAU组及正常组,进行两组间患者临床和生化指标的比较,并进行MAU与致动脉硬化危险因素间的相关性分析。结果 (1)两组在性别、年龄、体重指数、收缩压、吸烟史、糖尿病病程、糖化血红蛋白、空腹血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血肌酐、尿酸、胰岛素抵抗指数等方面比较差异有统计学意义(P<0.05);(2)Logistic回归分析显示,体重指数(OR=1.137,95%CI:1.061～1.218)、收缩压(OR=1.033,95%CI:1.023～1.043)、糖尿病病程(OR=1.082,95%CI:1.056～1.108)、糖化血红蛋白(OR=1.172,95%CI:1.019～1.349)、低密度脂蛋白胆固醇(OR=1.346,,95%CI:1.090～1.661)是MAU发生的独立危险因素。结论 T2DM患者MAU的发生与体重指数、收缩压、糖尿病病程、糖化血红蛋白、低密度脂蛋白胆固醇密切相关。

Objective To investigate the association between microalbuminuria（ MAU ） and risk factors for atherosclerosis in type ：2 diabetes mellitus （ T2DM ）. Methods 1004 patients with T2DM （ Between 1995 and 2009, Beijing Hospital） were divided into 2 groups （mieroalbuminuria subgroup and normal albuminuria sub- group）. The comparison of clinical and biochemical characteristics between 2 groups was performed. The correla- tion of UAER to risk factors for atherosclerosis in patients with T2DM was analyzed. Results （ 1 ） The differences in sex, age, BMI, SBP, history of smoking, duration of DM, HbAl c, FBG, LDL-C, HDL-C, Cre, URIC, HOMA-IR between 2 groups were statistically significant. （ 2 ） Logistic multiple regression analysis shown that BMI （ OR = 1.137, P = O. 000,95 % CI ： 1. 061 - 1.218 ）, SBP （ OR = 1. 033, P = 0. 000,95 % CI ： 1. 023 - 1. 043 ）, duration of DM（OR = 1.082,P = 0.000,95% CI： 1.056 - 1. 108） , HbAlc （OR = 1. 172,P = 0.026,95% CI： 1.019 1. 349） ,LDL-C（ OR = 1. 346,P = 0. 006,95% CI： 1. 090 ~ 1. 661 ） were the independent risk factors of the pro- gress of MAU. Conclusion The occurrence of MAU in T2DM was closely related to BMI, SBP, duration of DM, HbA1c, LDL-C.