2型糖尿病患者尿酸 血脂水平与糖尿病肾病的相关性研究

Clinical significance of determination of blood lipid and serum uric acid levels in patients with type 2 diabetic nephropathy

目的探讨尿酸、血脂与糖尿病肾病(DN)的相关性,为早期诊断及治疗糖尿病肾病提供参考。方法根据尿白蛋白肌酐比值(UACR)将130例2型糖尿病患者分为DN组80例和非DN组50例,其中DN组又分为微量白蛋白组40例和临床白蛋白组40例。分别测定UACR、肌酐(CREA)、尿酸(UA)、胱抑素C(CysC)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、脂蛋白α(LPα)。结果临床白蛋白组CREA、UA、CysC、TC、TG、LDL、LPα均显著高于非DN组,差异有统计学意义(P<0.05),HDL显著低于非DN组,差异有统计学意义(P<0.05)。微量白蛋白组仅有TG高于非DN组,差异有统计学意义(P<0.05)。临床白蛋白组CREA、CysC、TC、LDL、LPα均高于微量白蛋白组,HDL低于微量白蛋白组,差异有统计学意义(P<0.05)。DN组UA与CREA、CysC呈正相关(P<0.05)。结论 UA与糖尿病肾病的进展有一定关联,并且随着肾功能损害的加重UA水平升高,UA可作为评估2型糖尿病肾病进展的指标。高血脂促进糖尿病肾病的发生和发展,糖尿病肾病则可加重血脂紊乱,治疗2型糖尿病时要积极纠正脂代谢紊乱。

Objective To investigate the correlation between serum uric acid,blood lipid and diabetic nephropathy (DN) and provide more references for the early diagnosis and treatment of diabetic nephropathy. Methods According to the result of UACR,130 patients with type 2 diabetes mellitus (T2DM) were divided into simple diabetes mellitus without nephropathy group, early diabetic nephropathy group and clinical diabetic nephropathy group. Serum level of their UACR、creatinine(CREA)、uric acid(UA)、Cystatin?C(CysC)、total cholesterol(TC)、triglycerides(TG)、high density lipoprotein(HDL)、low density lipoprotein(LDL)、lipoprotein α(LPα). Results There are significantly statistical difference of CREA、UA、CysC、TC、TG、LDL、LPα、HDL levels in clinical diabetic nephropathy group as compared with that of simple diabetes mellitus without nephropathy group(P<0.05).TG levels in early diabetic nephropathy group were significantly higher than those in simple diabetes mellitus without nephropathy group(P<0.05).There are significantly statistical difference of CREA、CysC、TC、LDL、LPα、HDL levels in clinical diabetic nephropathy group as compared with that of early diabetic nephropathy group(P<0.05).CREA and CysC in patitnts with diabetic nephropathy were positively correlated with UA(P<0.05).Conclusion UA is associated with the progression of diabetic nephropathy as the level of UA increases with renal impairment, and can be used as an indicator to assess the progression of type 2 diabetic nephropathy. Hyperlipidemia promotes the occurrence and development of diabetic nephropathy and diabetic nephropathy aggravates dyslipidemia. The disorder of lipid metabolism should be corrected actively when treating type 2 diabetes.