老年2型糖尿病患者血清肾素水平及其与糖尿病Ⅲ期、Ⅳ期肾病及血管钙化的相关性

The relationship between the serum renin level and stage Ⅲ and Ⅳ diabetes nephropathy,vascular calcification in elderly patients with type 2 diabetes mellitus

目的研究老年2型糖尿病患者血清肾素(PRA)水平及其与糖尿病Ⅲ期、Ⅳ期肾病及血管钙化的相关性。方法选取老年2型糖尿病患者300例作为研究对象,根据有无合并糖尿病Ⅲ期、Ⅳ期肾病分为对照组(167例)和病例组(133例),比较两组血清肾素(PRA)浓度。取PRA正常范围低限值[PRA 2 ng/(ml·h)]为界,以PRA<2 ng/(ml·h)为暴露,PRA≥2 ng/(ml·h)为非暴露,分析PRA水平与糖尿病Ⅲ期、Ⅳ期肾病的关系;根据胸片主动脉弓钙化情况,进一步将病例组分为伴主动脉弓钙化组与无主动脉弓钙化组,比较血清PRA浓度差异。结果病例组血清PRA水平低于对照组(P<0.05);当PRA低于正常范围时[PRA<2 ng/(ml·h)],糖尿病患者发生Ⅲ期、Ⅳ期肾病的危险性增加7.671倍(OR=7.671,95%CI 4.912~14.763);病例组中伴主动脉弓钙化组血清PRA浓度显著高于无主动脉弓钙化组(P<0.05)。结论血清PRA水平与老年2型糖尿病患者发生Ⅲ期、Ⅳ期肾病及血管钙化相关,其水平降低会增加Ⅲ期、Ⅳ期肾病及血管钙化风险。

Objective To explore the relationship between the serum renin(PRA) level and stage Ⅲ and Ⅳ diabetes nephropathy,vascular calcification in elderly patients with type 2 diabetes mellitus.Methods 300 elderly patients with type 2 diabetes mellitus were divided into control group(167 cases) and case group(133 cases) according to whether the patients had diabetic nephropathy stage Ⅲ and Ⅳ, the level of PRA was compared between the two groups. The low limit of PRA normal activity range[(2 ng/ml·h)] was as the boundry, with PRA<2 ng/(ml·h) for exposed, PRA≥2 ng/(ml·h) for not exposed, the relationship between PRA level and stage Ⅲ and Ⅳ diabetes nephropathy was analyzed. Based on the calcification of the thoracic aorta arch, the case group was further divided into aortic arch calcification and non-aortic arch calcification groups, then the difference of serum PRA level had been compared.Results The serum PRA level in case group was lower than that of control group(P<0.05). With PRA<2 ng/(ml·h) for exposed, when PRA was lower than the normal range [PRA<2 ng/(ml·h)], the risk of stage Ⅲ and Ⅳdiabetes nephropathy was increased by 7.671 times(OR=7.671,95%CI 4.912~14.763).The level serum PRA in case group was lower than that of non-aortic arch calcification group(P<0.05).Conclusions Serum PRA level is associated with the risk of stage Ⅲ and Ⅳ diabetes nephropathy and vascular calcification.