糖化白蛋白与糖尿病视网膜病变、糖尿病肾病及糖尿病周围神经病变的相关性

Relationship between glycated albumin level and diabetic retinopathy,diabetic nephropathy,diabetic peripheral neuropathy

目的探讨糖化白蛋白(glycosylated albumin,GA)与糖尿病视网膜病变、糖尿病肾病及糖尿病周围神经病变的相关性。方法选取2015年5月至2016年2月在复旦大学附属中山医院就诊的糖尿病患者300例,采用液态酶法检测血清GA,同时检测糖化血红蛋白(glycosylated hemoglobin,HbA1c)等其他生化指标,记录患者身高、体重、糖尿病病程及并发症等信息。结果糖尿病肾病组中GA(%)高于无并发症组[22.6(18.0~28.2)vs.20.1(17.6~25.0),P=0.012]。Person相关性分析发现,HbA1c(r=0.818,P<0.001)、空腹血糖(r=0.534,P<0.001)、总胆红素(r=0.129,P=0.025)和丙氨酸氨基转移酶(r=0.276,P<0.001)与GA呈正相关,而体重指数(r=-0.131,P=0.024)、肌酐(r=-0.117,P=0.043)、尿酸(r=-0.213,P<0.001)及同型半胱氨酸(r=-0.130,P=0.024)与GA呈负相关。多因素非条件Logistic回归模型表明GA是糖尿病肾病的独立危险因素(OR=1.148)。结论 GA与糖尿病肾病密切相关,是糖尿病肾病的独立危险因素。

Objective To investigate the relationship between glycated albumin （GA） levels and diabetic retinopathy （DR） ,diabetic nephropathy （DN） ,diabetic peripheral neuropathy （DPN）. Methods From May 2015 to Feb. 2016, 300 patients with diabetes mellitus in Zhongshan Hospital, Fudan University were enrolled in the study. We used liquid enzymatic method to detect GA, and we also detected some other biochemical indicators like glycosylated hemoglobin （HbA1c）. The patients＇ height,weight,duration of diabetes and other information were recorded. Results GA in patients with DN was higher compared with patients without DN [22.6（18.0- 28.2） vs. 20.1 （17.6 -25.0）, P=0.012]. Through Person correlation analysis,HbAlc （r =0. 818,P〈0. 001） ,glucose （GLU） （r 0. 534,P〈0. 001） ,total bilirubin （TB） （r 0. 129,P 〈0.025） and alanine aminotransferase （ALT） （r=0.276,P〈0. 001） were positively correlated with GA, while BMI （r =-0.131,P 0.024）, creatinine （CREA） （r=-0. 117,P〈0. 043）, uric acid （UA） （r=-0. 213,P〈0. 001） and homocysteine （HCY） （r=-0. 130, P=0. 024） were negatively correlated with GA. The muhi variables non conditional Logistic regression model also showed that GA was an independent risk factor for DN （OR 1. 148）. Conclusions GA is closely related to DN,and it＇s an independent risk factor for DN.