血清C反应蛋白与2型糖尿病肾病的相关性分析

Analysis on correlation between serum C-reactive protein and type 2 diabetic nephropathy

目的探讨2型糖尿病(T2DM)患者血清C反应蛋白(CRP)与糖尿病肾病(DN)的相关性。方法将372例T2DM患者依据不同程度尿微量白蛋白(m-A1b)指标分三组:A组(单纯糖尿病组)m-A1b<20 mg/L,B组(早期糖尿病肾病组)20 mg/L≤m-A1b<200 mg/L,C组(临床糖尿病肾病组)m-A1b≥200 mg/L;按不同病程也分三组:A组病程<5年,B组为5年≤病程<15年,C组病程≥15年。比较各组间相关临床指标的水平,进行多元逐步回归分析。结果 DM病程、CRP、SBP、DBP在m-A1b不同组之间具有统计学差异(P<0.05);DM病程、体质量指数(BMI)、SBP、DBP、空腹血糖(FBG)、空腹胰岛素、餐后胰岛素在不同病程组中比较,具有统计学差异(P<0.05),CRP与m-A1b、糖化血红蛋白A1c(HbA1c)(P<0.001)呈独立正相关、与FBG(P<0.05)和低密度脂蛋白胆固醇(LDL-C)(P<0.01)呈独立负相关。结论 T2DM患者的CRP水平与DN的发生、发展有着密切的关系,随着DN的进展,CRP逐渐升高,且多元回归提示CRP与m-A1b、HbA1c呈明显正相关,提示炎症可能参与DN的发生与发展,是预测DN进展的一个重要指标。

Objective To study the correlation between serum C-reactive protein （CRP） and diabetic nephropathy （DN） in the patients with type 2 diabetes mellitus （T2DM）. Methods A total of 372 T2DM patients were divided into three groups based on u- rine micro-albumin （m-Alb） , i. e. Group A （ simple diabetes group, m-Alb 〈 20 mg/L）, Group B （ early DN group, 20 mg/L ≤ Alb 〈 200 mg/L） and Group C （clinical DN group, m-Alb ≥ 200 mg/L）. According to the course of the disease, they were also divided into three groups ： Group A（ course 〈 5 years）, Group B（5 ≤ course 〈 15 years） and Group C （ course ≥ 15 years）. Com- parison on some clinical indicators was done among the groups, and muhiple stepwise regression analysis was carried out. Results DM duration, CRP, systolic blood pressure （SBP） and diastolic blood pressure （DBP） were statistically different among the groups with different m-Alb level （ P 〈 0.05 ）. DM duration, body mass index （ BMI）, SBP, DBP, fasting blood glucose （ FBG）, fasting insulin and postprandial insulin were statistically different among the groups with different disease course （P 〈 0.05）. CRP was independently positive correlated with m-Alb and glycosylated hemoglobin （HbAlc） （P 〈 0. 001 ）, and independently negative cor- related with FBG and low density lipoprotein-cholesterol （LDL-C） （P 〈 0. 05, P 〈 0.01 ）. Conclusion In T2DM patients, CRP has close relationship with the occurrence and the development of DN. Its level goes up along with the progress of DN. CRP is positively correlative with m-Alb and HbAlc. It is suggested that inflammation may be involved in the occurrence and the develop- ment of DN.