2型糖尿病患者尿白蛋白排出量与大血管病变的关系

The relationship between microalbuminuria and atherosclerotic vascular disease in type 2 diabetes

目的 研究微量白蛋白尿与 2型糖尿病早期大血管病变的关系。方法 采用高分辨率的彩色多普勒超声波仪器测量伴有不同程度白蛋白尿的 2型糖尿病患者颈总动脉内膜 -中层厚度 (IMT)及胫前动脉内径。结果 伴微量白蛋白尿及明显蛋白尿的糖尿病病人其颈动脉 IMT大于尿蛋白正常的糖尿病病人 (0 .6 5± 0 .12 mm vs 0 .48± 0 .0 6 mm,P<0 .0 0 1) ,而胫前动脉内径小于后者 (1.98± 0 .49mm vs 2 .45± 0 .30 mm,P<0 .0 1)。结论 伴微量白蛋白尿的糖尿病患者存在早期大血管病变。

Objective To investigate the associations between microalbuminuria and early atherosclerosis in type 2 diabetes.Methods We measured the combined intima-media thickness (IMT) of the common carotid arteries and the inner diameter (ID) of tibia artery with high resolution ultrasound in 30 type 2 diabetic patients,and compared with 13 age-matched non-diabetics as control.The diabetic patients were subgrouped into DM-A subjects whose urinary albumin excretion were normal,and DM-B subjects who were with microalbuminuria,and DM-C subjects who with macroalbuminuria.Results The results showed that the IMT values were greater in diabetic patients than in control subjects (0.65 ±0.12 mm vs 0.48±0.06mm, P <0.001),and greater in group of DM-B and DM-C than in group of DM-A.The ID of tibia artery were smaller in diabetic subjects than in controls (1.98±0.49mm vs 2.45±0.30mm, P <0.01),and smaller in DM-B and DM-C group than DM-A.Besides,multiple linear regression analysis demonstrated that the risk factors for IMT and ID of tibia artery of type 2 diabetes were diabetic duration,total cholesterol levels,blood pressure and urinary albumin excretion.Conclusion It can be concluded that microalbuminuria is related to atherosclerosis at early stage of the disease process.