尿白蛋白排泄率与2型糖尿病早期大血管病变的关系

The Association between Urinary Albumin Excretion Rate and Early Macrovascular Complications in Type 2 Diabetes

目的探讨2型糖尿病(T2DM)患者尿白蛋白排泄率(UAER)与颈动脉内膜中层厚度(CIMT)的相关关系。方法将302名T2DM住院患者根据UAER分为正常白蛋白尿组(UAER<20μg/min)103例,微量白蛋白尿组(UAER20～200μg/min)107例,临床白蛋白尿组(UAER>200μg/min)92例。所有患者均采用高分辨率超声测量CIMT水平;多因素线性相关分析UAER和CIMT的关系。结果三组间年龄、性别、体质指数具有可比性(P>0.05)。与正常白蛋白尿组相比,微量白蛋白尿组CIMT增厚,差异具有统计学意义(P<0.05);与正常白蛋白尿组及微量白蛋白尿组相比,临床白蛋白尿组CIMT增厚,差异均具有统计学意义(P<0.05)。多因素线性相关显示,UAER与CIMT呈显著正相关(r=0.716,P<0.001)。结论 UAER与CIMT关系密切,UAER水平升高是2型糖尿病患者早期大血管病变的重要危险因素。

Objective To investigate the association between urinary albumin excretion rate （UAER） and the carotid intimamedia thickness （CIMT） in type 2 diabetes. Methods The 302 subjects with type 2 diabetes were divided into three groups according to UAER levels： 103 with normal albuminuria （UAER〈20 μg/min）, 107 with microalbuminuria（ UAER 20-200 μg/min ） and 92 with clinical albuminuria （UAER 〉200 μg/min）. The levels of CIMT were measured with high resolution ultrasound. Muhivariable correlate analysis was used to analyze the relation between UAER and CIMT. Results Age, sex and BMI were similar among the three groups. In the microalbuminuria group, CIMT was increased than that in the normal albuminuria group （P〈 0.05）. In the clinical albuminuria group, CIMT was significantly increased than that in the microalbuminuria group and normal albuminuria group （P〈0.05）. There was a positive correlation between UAER and CIMT （r=0.716, P〈0.001）. Conclusion UAER is closely related with CIMT. Higher UAER level is an important risk factor for early macrovascular disease in type 2 diabetic patients.