2型糖尿病患者肾结石临床特征及危险因素分析

Clinical features and risk factors in type 2 diabetes mellitus patients complicated with kidney stones

目的:探讨2型糖尿病(T2DM)患者伴发肾结石的临床特征及危险因素。方法:选取T2DM伴肾结石患者48例设为观察组,同时选取T2DM不伴发肾结石患者48例为对照组,检测两组患者糖化血红蛋白(Hb A1c)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、空腹胰岛素(FINS)、餐后2 h血糖(2 h PBG)、空腹血糖(FBG)、尿p H值等指标。结果:观察组TG、FINS、LDL-C和胰岛素抵抗指数(HOMA-IR)明显高于对照组,而尿p H值和HDL-C明显低于对照组,差异有统计学意义(P<0.05);非条件Logistic分析结果显示尿p H值、HOMA-IR是T2DM伴肾结石发生的独立危险因素,其中尿p H值的OR值最高。结论:胰岛素抵抗、脂代谢紊乱以及尿p H值在T2DM伴肾结石疾病发生过程中有重要作用,其中尿p H值、HOMA-IR是T2DM伴肾结石的独立危险因素。

Objective： To investigate the clinical features and risk factors of type 2 diabetes mellitus（ T2DM）complicated with kidney stones. Methods： Forty-eitht T2 DM patients complicated with kidney stones treated in our hospital were selected as observation group,and 48 T2 DM patients without kidney stones were used as control group. The levels of glycosylated hemoglobin（ Hb A1c）,total cholesterol（ TC）,triglyceroles（ TG）,low density lipoprotein cholesterol（ LDL-C）,high density lipoprotein cholesterol（ HDL-C）,2-hour postprandial blood glucose（ 2 h PBG）,fasting insulin（ FINS） and urine p H value were examined in patients of the two groups. Results： The results showed that the levels of TG,FINS,LDL-C and insulin resistance index（ HOMA-IR） in the observation group were significantly higher than those in the control group,while the levels of urine p H value and HDL-C were markedly lower than those in the control group with statistically significant difference（ P 〈 0. 05）. Non-conditional Logistic regression analysis showed that urine p H value and HOMA-IR were independent risk factors of T2 DM with kidney stones,the OR of urine p H value being the highest. Conclusion： Insulin resistance,lipid metabolism disorder and urine p H value play important roles in the pathogenesis of T2 DM with kidney stones. Urine p H value and HOMA-IR are independent risk factors of T2 DM with kidney stones.