早期糖尿病肾病血糖波动对尿微量白蛋白及炎症因子水平的影响

Influence of Glycemic excursion on urinary albumin excretion and inflammatory factor in patients with early diabetes kidney disease

目的:研究早期糖尿病肾病血糖波动对尿微量白蛋白及炎症因子水平的影响。方法:收集本院确诊的早期糖尿病肾病96例,采用动态血糖监测仪(CGMS,美国MiniMed Inc生产)监测72h血糖,比较平均血糖波动幅度对尿蛋白排泄及IGF-1、FKN、IL-6、TNF-α、hs-CRP等炎症指标水平的影响。结果:本组血糖平稳者(MAGE<5.0mmol/L)与血糖波动者(MAGE≥5.0mmol/L)相比较,尿蛋白排泄率、1,5-AG相比较,差异均具有统计学意义(P<0.05);HbA1c、FA差异无统计学意义(P>0.05)。以MAGE作为因变量对尿蛋白排泄率进行Pearson相关分析结果显示呈正相关(r=0.759,P=0.009)。本组血糖平稳者(MAGE<5.0mmol/L)IGF-1、FKN、IL-6、TNF-α、hs-CRP等炎症指标水平分别与血糖波动者(MAGE≥5.0mmol/L)相比较,差异均具有统计学意义(P<0.05)。结论:血糖波动加剧可能通过促进机体炎症水平加重早期糖尿病肾病肾损害。

Objective：To investigate the influence of glycemic excursion on urinary albumin excretion andinflammatory factor in early diabetes kidney disease.Methods：A total of 96 patients with early diabetes kidney disease accepted regular drug therapy were recruited and given continuing glycemic monitor for 72 h.MAGE（Mean amplitude of glycemic excursion）was analyzed and the inflammatory factors including IGF-1,FKN,IL-6,TNF-α,hs-CRP were tested and compared according to glycemic fluctuation.Results：Comparing cases with MAGE5.0mmol/L to those with MAGE≥5.0mmol/L,UAER and 1,5-AG showed significant difference（t1=15.269,P1=0.003;t2=13.458,P2=0.007）,while HbA1 cand FA showed no significant difference（t1=4.254,P1=0.102;t2=5.336,P2=0.078）.Pearson correlation analysis between MAGE and UAER showed strong correlation（r=0.759,P=0.009）.Levels of front inflammatory factor including IGF-1、FKN、IL-6、TNF-、hs-CRP were all lower than that in cases with MAGE≥5.0mmol/L（P〈0.05）.Conclusion：Glycemic excursion may accelerate progression of kidney injury through inflammatory factors,and it needs further attention.