摘要
目的探讨老年2型糖尿病患者血浆纤维蛋白原(FIB)及非高密度脂蛋白胆固醇(non-HDL-C)水平与糖尿病肾病的相关性。方法将152例老年2型糖尿病患者(年龄≥60岁)根据24h尿白蛋白排泄率,分为正常白蛋白尿(89例)、异常白蛋白尿两组(63例),分别测定体质指数(BMI)、收缩压、舒张压、空腹血糖(FPG)、餐后血糖(2hPG)、糖化血红蛋白(HbAlc)、血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDI,C)、低密度脂蛋白胆固醇(LDL—C)、FIB及24h尿白蛋白量(uAER)等,并计算non-HDL—C与估算肾小球滤过率(eGFR)。结果异常白蛋白尿组患者的年龄、并存高血压病史患者数、收缩压、Scr、FIB分别为(74.6土7.3)岁、57例(90.5%)、(146.8±23.2)mmHg、(1.0±0.7)mol/L、(4.8±1.5)g/I。,与正常白蛋白尿组(71.6土7.2)岁、59例(66.3%)、(137.7士19.2)mmHg、(0.8_4-0.3)/,mol/L、(4.2±1.3)g/L比较均明显升高(t==2.536、=2.656、=2.474、=2.857,7。=11.936,均P〈O.05);而异常白蛋白尿组患者eGFR(68.5±31.2)ml·min。·1.73m~,比正常白蛋白尿组(81.4±25.9)ml·min^-1·1.73m。明显下降(t=2.791,P〈0.05)。异常白蛋白尿患者中FIB升高患者数中(45例,71.4%),明显高于FIB正常患者数(18例,28.6%)(y。:8.085,P=0.004);且FIB升高组(88例)的异常白蛋白尿患者的eGFR(62.6±30.5)ml·min^-1·1.73m,明显低于FIB正常组(64例)(83.2±28.7)ml·min^-1·1.73m。(t=2.459,P=0.017)。Pearson相关分析显示,UAER与non-HDL—C、TG、TC、FIB均呈正相关(r=0.276、0.268、0.243、0.176,均P〈0.05);进=步多元逐步回归分析结果显示,FIB是影响老年2型糖尿病患者白蛋白尿的独立危险因素(标准化偏回归系数β=0.166,P〈0.05)。结论FIB、non—HDL—C水平的升高与老年人2型糖尿病肾病的发生密切相关。
Objective To investigate the relationship oi plasma hbrmogen (PII3) and non-hLgh- density lipoprotein cholesterol (non-HDL-C) with diabetic nephropathy in the elderly with type 2 diabetes. Methods Totally 152 patients (aged 60 years and over) with type 2 diabetics were divided into normal albuminuria (UAER〈30 mg/24 h, n=89) and abnormal albuminuria (UAER》30 mg/ 24 h, n=63) groups, with high FIB (〉4.00 g/L, n=88) and normal FTB (2.00-4.00 g/L, n=64) sub-groups. The body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), postprandial blood glucose (2 hPG), glycated hemoglobin (HbAlc), serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), FIB and 24-hour urinary albumin excretion rate (UAER) were measured. The non-HDL-C and estimated glomerular filtration rate (eGFR) were calculated. Results Compared with normal albuminuria group, the values of age, hypertension rate, SBP, Scr and FIB in abnormal albuminuria group were increased[(74.6%7.3)years, 57 cases (90.5%), (146.8%23.2)mm Hg, (1.0±0.7) 9mol/L, (4.8β1.5) g/L vs. (71.6~7.2)years, 59 eases (66.3~), (137.7±19.2) mm Hg, (0. 8 -- 0. 3) mol/L, (4.2~Conclusions Higher levels of FIB and non-HDL-C are well correlated with diabetic nephropathy in the elderly with type 2 diabetes.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2012年第5期402-405,共4页
Chinese Journal of Geriatrics