2型糖尿病人群肾功能异常影响因素分析

Analysis on the influencing factors of renal dysfunction in people with type 2 diabetes mellitus

目的了解在社区管理的2型糖尿病人群肾功能异常现状以及其影响因素。方法于2014年,在淮安市招募了9 413名前期已纳入基本公共卫生服务管理的2型糖尿病患者进行问卷调查、体格检查和生化指标检测,以肾小球滤过率作为主要评价指标。结果 2型糖尿病患者肾小球滤过率(estimated glomerular filtration rate,e GFR)的平均水平为91 ml/(min·1.73 m^2),eGFR<60 ml/(min·1.73 m^2)达10.56%;不同性别、不同年龄人群间肾功能异常率差异有统计学意义(x^2=6.306,P=0.012;x^2=269.293,P<0.001),男性低于女性,年龄越大肾功能越差。多元分析表明,糖尿病病程、低密度脂蛋白、总胆固醇、甘油三酯的升高、血糖没有控制及患高血压等是肾功能下降的主要危险因素。结论 2型糖尿病人群易罹患肾功能异常,在健康管理中要加以关注。控制好血糖、血压和血脂对延缓2型糖尿病人群肾脏功能进一步恶化有帮助。

Objective To understand the status of renal function abnormalities and explore its influencing factors in a community-based population with type 2 diabetes mellitus （T2DM）.Methods Totally 9 413 patients with T2DM who have registered and received management of community public health service in 2014 were recruited in our study.All participants undertook questionnaire survey,physical examination and laboratory test.A simplified MDRD formula was used for estimating Glomerular Filtration Rate （eGFR）,and Logistic Regression method was used to analyze the risk factors.Results The average eGFR was 91 ml/min · 1.73 m2 and the attack rate of people with eGFR 〈60 ml/min 1.73 m2 was 10.56%.The difference of renal function in participants with different age and gender was significant（x2 =6.306,P =0.012;x2 =269.293,P 〈 0.001）.Renal function in male patients and older patients was more worse.Multivariate analysis showed that long duration of diabetes,high levels of low density lipoprotein （LDL）,total cholesterol （TC） and triglycerides （TG）,uncontrolled blood glucose were independent risk factors for renal dysfunction.Conclusions Patients with T2DM are susceptible to renal function abnormalities.Comprehensively control of blood glucose,blood lipid and blood pressure should be performed to decrease the risk of the disease.