高盐摄ty 促进糖尿病合并高血压患者肾脏早期损害的研究

The relationship of high sodium intake and early renal damage in diabetic patients with hypertension

目的探讨糖尿病合并高血压患者高盐摄入与。肾脏早期损害的关系。方法对341例2型糖尿病合并高血压患者测定24h尿钠、尿微量白蛋白及血脂谱、血尿酸等相关生化指标，根据公式将尿钠换算成摄盐量。用单因素方差分析患者基本资料相关分析摄盐量与尿蛋白关系、Logistic回归分析评估尿微量白蛋白的潜在危险因素。结果根据摄盐量检测结果，将患者分为低摄盐组、低中摄盐组、中高摄盐组和高摄盐组。高摄盐组尿微量白蛋白显著高于低摄盐组（P〈0．05）；24h尿钠、腰围、收缩压（SBP）、血尿酸、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）与尿微量白蛋白呈正相关（P〈0．05），Logistic回归分析结果显示24h尿钠、SBP、尿酸、糖化血红蛋白是24h尿微量白蛋白增高的独立危险因素。结论高盐摄入和高尿酸血症促进糖尿病合并高血压患者肾脏早期损害。

Objective To investigate the relationship between high sodium intake and early renal damage in diabetic patients with hypertension. Methods 24-hour urinary sodium excretion, urinary microalbumin,lipid profiles and serum uric acid were measured in 341 diabetic patients with hypertension. Daily sodium intake was derived from 24-hour urinary sodium excretion. Baseline characteristics of the patients were compared by one-way analysis of variance（ANOVA）. Pearson correlation analysis was used to determine the relation between sodium intake and urinary microalbumin, and logistic regression analysis was performed to assess the potential risk factors influencing urinary microalbumin. Results All patients were divided into 4 groups as low-,low-medium-, medium-high-, and high-sodium intake groups, according to quartiles of the sodium intake. Urinary microalbumin was significantly increased in high-sodium intake group compared with low-sodium intake group （ P 〈 0.05 ）. The 24-hour urinary sodium excretion, waist circumference, systolic blood pressure （ SBP）, serum uric acid, low-density lipoprotein cholesterol （ LDL-C ） and total cholesterol（TC） were found to be positively correlated with urinary microalbumin （P 〈 0.05 ）. Furthermore, the 24-hour urinary sodium excretion, SBP, serum uric acid, and HbA1 c were found to be the independent risk factors for increased urinary microalbumin. Conclusion High sodium intake and hyperuricemia promote early renal damage in diabetic patients with hypertension.