2型糖尿病患者HbA1c是否达标对尿蛋白、血脂及肝酶的影响

Effect of HbA1c meeting the standard or not on microalbuminuria, blood lipids and liver enzymes in patients with type 2 diabetes

目的 探讨2型糖尿病患者HbA1c是否达标对尿蛋白、血脂及肝酶的影响.方法 采用多阶段分层整群抽样方法 回顾性分析457例已确诊2型糖尿病患者的资料,根据HbA1c结果 判定分为未达标组与达标组,采集患者一般资料及实验室相关指标等进行比较.结果 两组患者的尿微量白蛋白、血清甘油三酯及肝酶学指标（谷氨酰转肽酶、碱性磷酸酶、谷草转氨酶）结果 差异有统计学意义[（189.8±235.3）mg/dl vs（38.9±85.5）mg/dl、（2.64±2.99）mmol/L vs（2.02±1.50）mmol/L、（41.7±52.9）U/L vs（29.7±24.9）U/L、（83.6±28.6）U/L vs（74.3±25.8）U/L、（26.7±19.1）U/L vs（22.0±10.5）U/L,P＜0.05].HbA1c与尿微量白蛋白、谷氨酰转肽酶、碱性磷酸酶呈正相关（r=0.209、0.115、0.11,P＜0.01）.尿微量白蛋白是影响2型糖尿病患者HbA1c达标的独立危险因素（OR=1.009,P＜0.05）.结论 HbA1c达标与否对血糖外多种因素均有影响.

Objective To investigate the effect of HbA1c meeting the standard or not on microalbuminuria,blood lipids and liver enzymes in patients with type 2 diabetes.Methods A retrospective analysis was performed on 457 subjects who had type 2 diabetes.They were divided into substandard group and standard group according to HbA1c result.The general information and relevant laboratory indicators of patients were.collected and compared between two groups.Results The microalbuminuria,serum triglyceride and liver enzymes （glutamyl transpeptidase,alkaline phosphatase,aspertate aminotransferase） were significantly different between two groups [ （189.8 ± 235.3） mg/dl vs （38.9 ± 85.5） mg/dl,（2.64 ± 2.99） mmol/L vs （2.02 ± 1.50）mmol/L,（41.7 ±52.9）U/L vs （29.7 ±24.9）U/L,（83.6 ±28.6） U/L vs （74.3 ±25.8）U/L,（26.7 ±19.1）U/L vs （22.0 ±10.5） U/L,P 〈0.05].HbA1c level was positively correlated with microalbuminuria,glutamyl transpeptidase and alkaline phosphatase （r =0.209,0.115,0.11,P 〈0.01）.The microalbuminuria was an independent risk factor of affecting HbA1c to reach the standard （OR = 1.009,P 〈0.05）.Conclusions HbA1c meeting the standard or not can influence many factors except blood glucose.