载脂蛋白B/载脂蛋白AⅠ比值与2型糖尿病肾脏病的关系

The association between apoB/apoAⅠ ratio and diabetic kidney disease in type 2 diabetes mellitus

目的研究载脂蛋白B（apo B）/载脂蛋白AⅠ（apo AⅠ）比值与2型糖尿病（T2DM）并发糖尿病肾脏病（DKD）的关系。方法选择2012年6月~2015年1月我院内分泌科门诊及住院T2DM患者318例。DKD定义为2次尿白蛋白/尿肌酐比值（ACR）≥30mg/g。采用Logistic回归分析apo B/apo AⅠ比值与DKD的关系。结果 DKD组年龄、糖尿病病程、收缩压（SBP）、糖基化血红蛋白（Hb A1C）、胆固醇（TC）、非高密度脂蛋白-胆固醇（non-HDL-C）、apo B、apo B/apo AⅠ比值明显高于非DKD组。多因素Logistic回归分析显示,在所有血脂参数中,apo B/apo AⅠ比值是DKD的最强危险因素,其OR值为3.591（95%CI 1.543~5.424）。ROC曲线分析显示,apo B/apo AⅠ比值预测DKD的最佳切点为0.88,其敏感性和特异性分别为65.3%和76.3%。结论 apo B/apo AⅠ比值是DKD发生的独立危险因素。

Objective To evaluate the association between apolipoprotein B(apo B)/apolipoprotein AⅠ(apo AⅠ)ratio and diabetic kidney disease(DKD) in type 2 diabetes mellitus(T2DM). Methods 318 T2 DM patients were selected from Jun 2012 to Jan 2015.DKD was defined as urinary albumin-to-creatinine ratio(ACR)≥30mg/g twice.Logistic regression was used to analyze the relation between apo B/apo AⅠ ratio and DKD. Results The age,diabetic duration years,systolic pressure(SBP),hemoglobin A1C(Hb A1C),total cholesterol(TC),non-high density lipoprotein cholesterol(non-HDL-C),apo B and apo B/apo AⅠratio were significantly higher in DKD group than in non-DKD group. Multiple logistic regression analysis showed that apo B/apo AⅠratio was the strongest risk factor for DKD during all lipid parameters,whose OR ratio was 3.591(95%CI 1.543~5.424).The ROC curve analysis showed that the optimal apo B/apo AⅠratio cut off value for detecting DKD was 0.88,which had a sensitivity of 65.3% and a specificity of 76.3%. Conclusion Apo B/apo AⅠ ratio plays an important role in DKD.