2型糖尿病血糖控制水平与并发糖尿病肾病的风险研究

Relationship between control of blood glucose level and the risk of diabetic nephropathy in type 2 diabetic mellitus

目的探讨2型糖尿病(T2DM)患者血糖控制水平与并发糖尿病肾病风险的关系。方法根据糖化血红蛋白(HbA1c)的含量将2型糖尿病患者分成血糖控制良好组(HbA1c≤7.0%,n=72)、血糖控制不佳组(HbA1c>7.0%,n=32),分别检测血清中胱抑素C(Cys C)、肌酐(Cr)、尿素(Urea)、超敏C反应蛋白(hs-CRP)和尿液中视黄醇结合蛋白(U-RBP)、尿微量清蛋白(U-mAlb)等项目。结果糖尿病各组血清Cys C、hs-CRP、U-RBP和U-mAlb与对照组比较均升高(P<0.05或P<0.01),并且患者血糖控制水平越差,Cys C、hs-CRP、U-RBP和UmAlb升高幅度越大。结论 T2DM患者HbA1c水平越高,血糖控制越差,并发糖尿病肾病的风险就越高。因此,控制好血糖对预防或延缓T2DM患者并发糖尿病肾病具有重要意义。

Objective To investigate the relationship between the control of blood glucose level and the risk of diabetic nephropathy （DN） in patients with type 2 diabetic mellitus （T2DM）. Methods According to the level of glycosylated hemoglobin Alc （HbAlc）, T2DM patients were assigned into 2 groups, including tight blood glucose control group （HbAlc7.0% ,n=72） and loose blood glucose control group （HbAlc）7.0% ,n=32）. Serum levels of cystatin C （Cys C）, creatine（Cr）, urea,high sensitive C-reactive protein （hs-CRP） and urinary concentrations of retinol-binding protein （U-RBP）, microalbumine （U-mAlb） were measured respectively. Results Serum levels of Cys C,hs-CRP,U-RBP and U-mAlb in all diabetic groups were significantly higher than control group （P（0.05）, and worse blood glucose control could lead to higher level of serum Cys C,hs-CRP,U-RBP and U-mAlb（P〈0.05）. Conclusion The higher levels of HbAlc in patients T2DM,the higher risk of DN. Efficient control of blood glucose level could be important to prevent and postpone the incidence of DN in patients with T2DM.