2型糖尿病肾病与血胰岛素、糖化血红蛋白及肾功能的相关性研究

Correlation analysis of serum insulin,glycosylated hemoglobin and renal function with type 2 diabetic nephropathy

目的探讨T2DM肾病与Ins、HbA1c及肾功能的相关性。方法以健康体检者50例、T2DM无肾病组41例、T2DM肾病微量白蛋白尿组72例、T2DM肾病临床蛋白尿组58例作为研究对象,将各组Ins、HbA1c及肾功能等结果进行比较与分析。结果 T2DM肾病不同分期的各时段Ins与T2DM无肾病组比较差异均无统计学意义(P>0.05)。T2DM无肾病组、2个疾病组的FBG、HbA1c、TG与对照组比较差异均有统计学意义(P<0.05)。其他3组的UA、UREA、CREA、β2微球蛋白与T2DM肾病临床蛋白尿组比较差异均有统计学意义(P<0.05)。Spearman相关分析发现空腹Ins与各时段C肽、UA呈正相关(P<0.05),与HbA1c呈负相关(P<0.05);HbA1c与各时段Ins、各时段C肽、UA、CREA呈负相关(P<0.05)。结论血Ins、HbA1c及肾功能异常与T2DM肾病发生发展密切相关,降低HbA1c、CREA、UA及减少并发症对防治T2DM肾病有重要意义。

Objective To investigate correlation of serum insulin, glycosylated hemoglobin and renal function with type 2 dia- betic nephropathy. Methods The study enrolled 50 healthy people, 41 patients with T2DM without nephropathy, 72 patients with T2DM nephropathy microalbuminuria period, 58 patients with T2DM nephropathy clinical proteinuria period, and insulin, HbAlc and renal function results were compared and analyzed. Results The different stages of insulin in T2DM nephropathy group were compared with the T2DM without nephropathy group, with the differences not statistically significant （ P 〉 0.05 ）. FBG, HbA1 c, TG in T2DM without nephropathy group and 2 case groups were compared with the healthy control group, and the differences were statistically significant（P 〈0.05）. UA, UREA, CREA, beta 2 microspheres in other three groups were com- pared with the T＇2DM nephropathy clinical proteinuria period group, and the differences were statistically significant（ P 〈 0.05 ）. Spearman correlation analysis showed that fasting insulin was positively correlated with C peptide and UA in each stage （ P 〈 O. 05）, and negatively correlated with HbAlc （P 〈 0.05）. HbAlc was negatively correlated with insulin, C peptide, UA, CREA（P 〈 0.05 ）. Conclusion Serum insulin, HhAlc and renal dysfunction are closely related to the development and pro- gression of T2DM nephropathy. Reducing HbAlc, CREA, UA and the complications of prevention and treatment of T2DM ne- pbropathy are important.