太原市某医院2型糖尿病患者肾脏功能状况调查及影响因素分析

Survey the kidney function and the influence factors among type 2 diabetes mellitus patients in Taiyuan

目的调查2013年4~9月太原市某医院2型糖尿病患者肾功能状况,并揭示其可能的影响因素。方法选择太原市某医院2型糖尿病患者242例,通过调查问卷收集研究对象的基本信息,检测血压、血糖、血脂、糖化血红蛋白、尿肌酐,采用ELISA的方法检测尿N-乙酸-β-D-葡萄糖苷酶(UNAG)、尿白蛋白、尿肾脏损伤分子-1(Kim-1),并以尿肌酐进行校正计量资料比较采用方差分析,计数资料比较采用χ~2检验。用多因素非条件logistic回归分析筛选影响因素。结果男性血糖和糖化血红蛋白水平较女性高(P<0.01),UNAG、尿微量白蛋白(UALB)、UKim-1水平显示,女性高于男性。对不同饮酒情况的比较显示,不饮酒者UNAG、UALB和UKim-1显著高于饮酒者(P<0.01)。在糖尿病合并高血压者中也发现,UKim-1水平高于非高血压者。经非条件logistic回归分析显示性别(OR=9.217)和血糖(OR=6.923)是UNAG的危险因素,饮酒(OR=0.235)是UALB的保护因素,高血压(OR=4.394)是UKim-1的危险因素。结论 2型糖尿病、女性、血糖和高血压可能是影响肾功能的危险因素。

Objective To investigate the kidney function of type 2 diabetes mellitus and explore the influencing factors in Taiyuan. Methods Selected 242 type 2 diabetes mellitus patients as subjects. Questionnaire was used to collect the general information. Physical examination was also performed. Blood pressure, FPG, blood lipid, HbAlc and urinary creatinine （UCr） were detected. ELISA were used to measure urinary NAG, ALB and Kim 1, and all of the urinary index were corrected by UCr. Risk factors were analyzed by multilevel logis- tic regression. Results FPG and HblAc in males were higher than females （P^0.01） . The levels of UN AG, UALB and UKim-1 were higher in female patients. Comparing different drinking status, UNAG, UALB and UKirn-1 of nondrinkers were significantly higher than drinkers （P〈0. 01）. UKiml level in the diabetes combined with hypertension were higher than the subjects without hypertension. The logistic regression analysis showed that gender and FPG were the main factors of UNAG, and hypertension will increase the level of UKirn 1. Conclusions Female, FPG and hypertension were the risk factors of renal dysfunction in type 2 diabetes mellitus.