2型糖尿病患者合并尿路结石影响因素分析

Influencing factors for urinary calculi in patients with type 2 diabetes mellitus

目的分析住院T2DM合并尿路结石(UC)患者的临床特征及影响因素。方法收集2011年1月1日至2019年3月31日于北京大学人民医院内分泌科住院的1836例T2DM患者临床资料,回顾性分析合并UC患者临床特征。结果T2DM合并UC在eGFR<60 ml/(min·1.73 m^2)、60 ml/(min·1.73 m^2)≤eGFR<90 ml/(min·1.73 m^2)和eGFR≥90 ml/(min·1.73 m^2)组中患病率分别为9.8%、8.0%和4.2%(P<0.01),男性高于女性。其中男性较女性糖尿病病程长[11(7.3,15.8)vs9(3,15)年]、eGFR低[(98.86±16.41)vs(103.54±15.66)ml/(min·1.73 m^2)](P<0.05)。二元Logistic回归分析显示,血清白蛋白(β=0.023,P=0.022)、血肌酐(Scr)(β=0.027,P<0.001)是UC的影响因素。结论T2DM患者合并UC与肾功能相关,当Scr升高或eGFR下降时需早期筛查并干预。

ObjectiveTo investigate the clinical features and the influencing factors for urinary calculi in hospitalized patients with type 2 diabetes mellitus(T2 DM).MethodsThis study included 1836 hospitalized T2 DM patients from the Endocrinology Department of Peking University People’s Hospital from January 1 st,2011 to March 31 st,2019. The clinical and laboratory information were collected. The distribution of urinary calculi in each subgroup was analyzed.ResultsThe proportions of urinary calculi were significantly different among the three groups with various estimated glomerular filtration rate(e GFR)ranges:9. 8% in e GFR<60 ml/(min·1. 73 m^2),8. 0% in 60 ml/(min·1. 73 m^2)≤e GFR<90 ml/(min·1. 73 m^2)and 4. 2% in e GFR≥90 ml/(min·1. 73 m^2)group(P<0. 01). The proportion of male was higher,duration of diabetes was longer[11(7. 3,15. 8)vs 9(3,15)years]and e GFR[(98. 86±16. 41)vs(103. 54±15. 66)ml/(min·1. 73 m^2)]was lower in patients with urinary calculi than without urinary calculi(P<0. 05). Binary logistic regression analysis showed that urinary calculi was associated with serum albumin(β=0. 023,P=0. 022)and serum creatinine(β=0. 027,P<0. 001).ConclusionIn patients with T2 DM,urinary calculi was associated with renal function. Early screening and early intervention are required when patients show increased creatinine or decreased GFR.