住院2型糖尿病患者糖化血红蛋白与血肌酐 血β_2-MG的关系研究

Study on the relationship between glycosylated hemoglobin and serum creatinine,Beta 2 microglobulin in patients with type 2 diabetes mellitus

目的探讨住院2型糖尿病患者糖化血红蛋白(HbA_1c)与血肌酐(CR)、血β_2微球蛋白(β_2-MG)的关系。方法选取2014年1月—2016年12月我院内分泌科收治的1 331例住院2型糖尿病患者,检测HbA_1c,CR、β_2-MG水平,分析HbA_1c、CR、β_2-MG的相关性,并根据不同性别患者的HbA_1c水平将其分为3组:HbA_1c≤7%、7%<HbA_1c<10%、HbA_1c≥10%,分组后采用单因素方差分析比较各组CR、β_2-MG情况。结果HbA_1c与血CR(男:r=-0.181,女:r=-0.261)呈负相关,与血β_2-MG无相关性;按HbA_1c分组:HbA_1c≤7%、7%<HbA_1c<10%、HbA_1c≥10%,CR分别为男:(63.11±15.87)μmol/L、(61.16±15.84)μmol/L、(55.37±16.33)μmol/L(F=10.626,P<0.01);女:(57.92±13.53)μmol/L、(53.12±15.54)μmol/L、(46.65±13.44)μmol/L(F=30.257,P<0.01),男性HbA_1c≥10%组CR与前两组比较有统计学差异,女性3组间CR比较均有统计学差异。结论 2型糖尿病患者HbA_1c与CR呈负相关,在降血糖的同时一定要注意血CR水平,在监测糖尿病早期肾损害时,CR和β_2-MG并不是最佳的指标。

Objective Toinvestigate the relationship between glycosylated hemoglobin （HbA1c）and Serum creatinine （CR）,Beta2microglobulin（β 2 -MG）inpatientswithtype2diabetesmellitus.Methods 1331patientswith type2diabetesmellituswereselectedfrom theendocrinologydepartmentinourhospitalfrom January2014toDecember 2016.ThelevelsofHbA 1 c,CR and beta2-MG weredetected,and thecorrelationsbetween HbA 1 c,CR and beta2-MG wereanalyzed.AccordingtotheHbA1clevelofdifferentsexpatients,theyweredivided into3 groups：HbA1c〈7% ,7% 〈HbA 1 c〈10% and HbA1c 〉 10% .TheCR and β 2 -MG situation ofeach group were compared byone-way ANOVA. Results Therewasanegativecorrelation between HbA 1 cand blood CR （male：r=-0.181,female：r=-0.261）,butno correlationwithbloodβ 2 -MG.AccordingtotheHbA 1 cgrouping：HbA 1 c≤7% ,7% 〈 HbA 1 c〈10% ,HbA 1 c≥10% ,CR were（63.11±15.87）μmol/L, （61.16±15.84）μmol/L, （55.37±16.33）μmol/Linmale （F=10.626,P〈0.01）,CR were （57.92±13.53）μmol/L,（53.12±15.54）μmol/L,（46.65±13.44）μmol/Linfemale （F=30.257,P〈0.01）respectively. Therewerestatisticallysignificantdifferencesbetween theHbA 1 c≥10% groupscompared with thefirsttwogroupsin male.Thereweresignificantdifferencesamongthethreegroupsinfemale.Conclusion Therewasanegativecorrelation betweenHbA 1 candCR inpatientswithtype2diabetes..Patients mustpayattentiontothebloodCR levelwhilelowering bloodsugar.CR andβ 2 -MG arenotthebestmarkersformonitoringearlyrenaldamageindiabetesmellitus.