尿β2微球蛋白水平与2型糖尿病患者视网膜病变和肾脏病变的相关性

Correlation Between Urine β2 Microglobulin Level and Retinopathy and Nephropathy in Type 2 Diabetic Patients

目的探讨尿液内β2微球蛋白(β2-MG)水平与2型糖尿病视网膜病变和肾损伤的关系。方法选取2016年2月~2018年11月我院收治的409例2型糖尿病患者为研究对象,根据患者并发症发生情况分为对照组85例、糖尿病视网膜病变(DR)组168例和糖尿病肾损伤(DN)组156例,将糖尿病视网膜病变组进一步分为为非增生性视网膜病变(NPDR)组85例和增生性视网膜病变(PDR)组83例,将糖尿病肾损伤组进一步分为早期肾病组79例和临床肾病组77例。比较糖尿病视网膜病变组和糖尿病肾病组患者尿液β2-MG水平、UmAlb/UCr比值及GFR水平,并分析尿液β2-MG水平与糖尿病视网膜病变(DR)和糖尿病肾病(DN)严重程度的相关性。结果DR组和DN组尿β2-MG的水平高于对照组,DN组UmAlb/UCr比值及GFR水平高于对照组(P<0.05);PDR组尿β2-MG水平高于NPDR组,临床肾病组尿β2-MG的水平高于早期肾病组(P<0.05),但UmAlb/UCr比值及GFR水平与早期肾病组患者比较,差异无统计学意义(P>0.05)。Logistic多元回归分析显示,病程、β2-MG是2型糖尿病患者发生视网膜病变的危险因素,Spearman相关分析显示,尿β2-MG水平与DR和DN的严重程度呈正相关(P<0.05)。结论糖尿病微血管病变患者尿β2-MG的水平显著升高,可能作为诊断指标为2型DR和肾脏病变的早期诊断提供参考,但仍有待进一步研究。

Objective To investigate the relationship between the level of β2 microglobulin in urine and type 2 diabetic retinopathy and kidney injury.Methods 356 patients with type 2 diabetes who were admitted to our hospital from February 2016 to November 2018 were selected as the research objects.According to the complications of the patients,they were divided into control group 85 cases,diabetic retinopathy group 168 cases and diabetic kidney injury group 156 the diabetic retinopathy group was further divided into non-proliferative retinopathy(NPDR)group with 85 cases and proliferative retinopathy(PDR)group with 83 cases,and the diabetic kidney injury group was further divided into early nephropathy group with 79 cases and clinical nephropathy Group 77 cases.Compare the urineβ2-MG level,UmAlb/UCr ratio and GFR level of diabetic retinopathy group and diabetic nephropathy group,and analyze the correlation between urine β2-MG level and the severity of diabetic retinopathy(DR)and diabetic nephropathy(DN).Results The levels of urine β2-MG in the diabetic retinopathy group and the diabetic nephropathy group were higher than those in the control group.The UmAlb/UCr ratio and GFR level in the diabetic nephropathy group were higher than those in the control group(P<0.05);The level of urine β2-MG in the PDR group was higher than that in the NPDR group,and the level of urine β2-MG in the clinical nephropathy group was higher than that in the early nephropathy group(P<0.05),but the UmAlb/UCr ratio and GFR level were the same as those in the early nephropathy group,there was no statistically significant difference among patients(P>0.05).Logistic multiple regression analysis showed that the course of disease and β2-MG were risk factors for retinopathy in patients with type 2 diabetes.Spearman correlation analysis showed that urine β2-MG levels were positively correlated with the severity of DR and DN(P<0.05).Conclusion The level of urine β2-MG in patients with diabetic microangiopathy is significantly increased,which may be used as a diagnostic indicator to provide a reference for the early diagnosis of type 2 diabetic retinopathy and nephropathy,but further research is still needed.