新诊断2型糖尿病患者肾损伤的影响因素分析

Analysis of the renal damage-associated factors in patients with newly diagnosed type-2 diabetes

目的观察新诊断的2型糖尿病患者肾损伤特点,并分析相关影响因素。方法 120例新诊断2型糖尿病患者根据肾小球率过滤(glomerular filtration rate,GFR)分为G1组[GFR≥90 mL/(min·1.73m^2)]、G2组[GFR 60~89 mL/(min·1.73 m^2)]、G3组[GFR 45~59 mL/(min·1.73 m^2)],比较各组生化指标、血糖波动指标及炎症因子CRP水平。结果 G3组三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c%)、平均血糖漂移幅度(MAGE)、24 h平均血糖水平(24h MBG)、胰岛素抵抗指数(HOMA-IR)及GFR较G1组、G2组均升高(P<0.05);G2、G3组年龄较G1组高(P<0.05);年龄、TG、FPG、HbA1c%、MAGE、24h MBG、HOMA-IR及CRP与GFR呈负相关(P<0.05或P<0.01)。结论新诊断2型糖尿病患者存在早期肾损伤,高龄、高血糖、高血脂、血糖波动、炎症是新诊断2型糖尿病患者肾损伤的影响因素。

Objective To observe the characteristics of renal damages in patients with newly diagnosed type-2 diabetes and analyze the renal damage-associated factors. Methods 120 cases with newly diagnosed type-2 diabetes were divided into the G1, G2 and G3 groups based on the level of glomerular filtration rate （ GFR）. The levels of biochemical and blood glucose fluctuation indexes and c-reaction protein （CRP） in each group were examined. Results TG, FPG, HbAlc%, MAGE, 24 h MBG, HOMA-IR and GFR were significantly higher in the G3 group than the G1 and G2 groups （P〈0.05）. BTG, FPG, HbAlc%, MAGE, 24 h MBG, HOMA -IR and CRP were negatively related to GFR （P〈O.05 or P〈0.01）. Conclusion The newly diagnosed type-2 diabetic patients have early renal damage, and the renal damage-associated factors include old age, hyperglycemia, hypertriglyeeridemia, blood glucose fluctuation and inflammation.