2型糖尿病肾病与代谢综合征、血尿酸关系研究

Study of relation between type 2 diabetes nephropathy and metabolic syndrome, blood uric acid

目的探讨2型糖尿病肾病（DN）与代谢综合征（MS）及血尿酸（UA）的关系。方法选取北京同仁医院内分泌科1994年1月~2008年12月进行过核素肾动态显像测定肾小球滤过率（GFR）的2型糖尿病住院患者281例,根据尿微量白蛋白排泄率（UAER）分为两组：糖尿病无肾病组169例;糖尿病有肾病组112例。观察2型DN的GFR与MS、UA的关系。结果糖尿病有肾病组与糖尿病无肾病组比较,年龄、糖尿病病程、糖化血红蛋白（Hb A1c）、收缩压（SBP）、舒张压（DBP）、UA、总胆固醇（CHO）、低密度脂蛋白（LDL-C）均上升,GFR值降低,两组比较差异有统计学意义（P〈0.05）;糖尿病无肾病组与糖尿病有肾病组的MS患病率分别为52.7%、65.2%,差异有统计学意义（P〈0.05）。多元线性回归分析结果显示年龄、收缩压、UA与GFR呈独立负相关（r=-1.1、-0.18、-0.05,P〈0.01）。结论 MS、UA与2型DN密切相关。

Objective To discuss relation between type 2 diabetes nephropathy and metabolic syndrome（MS）, blood uric acid（UA）. Methods 281 cases of type 2 diabetes mellitus patients determined glomerular filtration rate（GFR） by radionuclide renal dynamic imaging in Department of Endocrinology, Beijing Tongren Hospital from January 1994 to December 2008 were selected and divided into two groups according to urinary albumin excretion rate（UAER）： diabetic without nephropathy group（n = 169）, diabetic nephropathy（DN） group（n = 112）. The relationship between GFR and MS, UA of DN patients was observed. Results Compared with diabetes without nephropathy group, levels of age, diabetic duration, glycated-hemoglobin（Hb A1c）, systolic blood pressure（SBP）, diastolic blood pressure（DBP）, total cholesterol（CHO）, triglyceride（TG）, lowdensity lipoprotein cholesterol（LDL-C）, high density lipoprotein cholesterol（HDL-C）of DN group rised, GFR level declined, with statistical significance（P〈0.05）. The incidence of MS was significantly higher in DN group（65.2%） than that in diabetes without nephropathy group（52.7%）, with statistical significance（P〈0.05）. Linear multiple regression analysis revealed that levels of age, SBP and UA were negatively correlated with GFR level（r =-1.1,-0.18,-0.05, P〈0.01）. Conclusion MS and UA levels are closely related to type 2 DN.