2型糖尿病患者糖化血红蛋白水平与糖尿病肾病的关系

Relationship of glycosylated hemoglobin to diabetic nephropathy in type 2 diabetic patients

目的探讨2型糖尿病患者糖化血红蛋白A1(HbA1c)水平与糖尿病肾病(DN)分期的关系。方法回顾性纳入97例2型糖尿病患者,依据尿微量清蛋白与尿肌酐比值对DN临床分期:正常清蛋白尿组(<30mg/g),微量清蛋白尿组(30～300mg/g),临床蛋白尿组(>300mg/g),记录患者的临床资料。结果年龄、糖尿病病程、收缩压、HbA1c水平随着糖尿病肾病分期依次升高(P<0.05),临床蛋白尿组年龄、糖尿病病程、收缩压、HbA1c分别为(57±15)岁、(11.2±6.2)年、(134±23)mm Hg、11.1%±1.9%。而体质量指数(BMI)在微量蛋白尿组与临床蛋白尿组差异无统计学意义(P>0.05),糖尿病病程、收缩压、HbA1c均与DN发生有关,是DN发病的独立危险因素。结论慢性高血糖参与了DN的发生发展过程,并与DN分期有关。

Objective To investigate the relationship between glycated hemoglobin （HbAlc） level and diabetic nephropathy （DN） in type 2 diabetic patients. Methods This is a retrospective study of 97 inpatients with type 2 dia- betes mellitus. Based on urine albumin and urine creatinine ratio, diabetic nephropathy is categorized into three groups： normal albuminuria group （mAlb/Cr〈30 mg/g）, microalbuminuria group （30〈mAlb/Cr〈300 mg/g） and macroalbuminuria group （mAlb/Cr〉300 mg/g）, according the patientg data. Results Compared with the normal al- buminuria group, age, duration of diabetes, blood pressure, HbAlc level were significantly increased in the other two groups （P〈0.05）, while there was no difference of body mass index （BMI） in the microalbuminuria and mac- roalbuminuria group （P〈0.05）. Associated risk factors of DN were the duration of diabetes, uncontrolled hyperten- sion and HbAlc level. Conclusion Chronic hyperglycemia has involved in the development, progression and stages of DN.