生化指标对2型糖尿病早期肾病的诊断及其进展风险的价值分析

The Value Analysis of Biochemical Indicators in the Diagnosis of Early Nephropathy of Type 2 Diabetes and the Risk of Its Progression

目的探讨生化指标在2型糖尿病(T2DM)并发糖尿病早期性肾病(DKD)患者中的变化及应用价值。方法依据尿白蛋白与尿肌酐比值(UACR),将2021年1—5月在福建医科大学附属协和医院内分泌科收治的190例2型糖尿病患者分为正常蛋白尿组、微量蛋白尿组和大量蛋白尿组;另选50名健康体检者作为对照组。比较无肾病单纯糖尿病组、微量蛋白尿组和大量蛋白尿组及对照组的各生化指标水平,研究各指标水平与DKD的相关性,并对有统计差异的指标用多元有序Logistic回归分析影响DKD进展的危险因素。结果C肽、空腹血糖、三酰甘油、尿素、肌酐、光抑素C、肾小球滤过率、尿微量白蛋白、尿α1微球蛋白和糖化血红蛋白水平、UACR与T2DM、DKD相关,差异有统计学意义(P<0.05)。尿素、肾小球滤过率和尿微量白蛋白水平对糖尿病肾病的进展存在显著性影响(P<0.05)。结论尿素、尿微量白蛋白是糖尿病并发糖尿病肾病及其进展的危险因素,肾小球滤过率为保护因素,这3个指标对DKD有重要的诊断和预测价值。

Objective To investigate the changes and application value of biochemical indicators in patients with type 2 diabetes(T2DM)complicated with early diabetic nephropathy(DKD).Methods Based on the ratio of urine albumin to urine creatinine(UACR),190 patients with type 2 diabetes who were admitted to the department of endocrinology,Fujian Medical University Affiliated Union Hospital from January to May 2021 were divided into a normal proteinuria group,a microalbuminuria group,and a microalbuminuria group and a large proteinuria group;another 50 healthy subjects were selected as the control group.Compare the levels of various biochemical indicators in the simple diabetes group without nephropathy,the microalbuminuria group,the macroalbuminuria group and the control group,study the correlation between the level of each indicator and DKD,and analyze the impact of the statistically different indicators with multivariate ordered Logistic regression risk factors for the progression of DKD.Results C peptide,fasting blood glucose,triacylglycerol,urea,creatinine,photostatin C,glomerular filtration rate,urinary microalbumin,urinaryα1 microglobulin and glycosylated hemoglobin levels,UACR were related to T2DM and DKD,and the differences were statistically significant(P<0.05).Urea,glomerular filtration rate and urinary microalbumin levels have significant effects on the progression of diabetic nephropathy(P<0.05).Conclusion Urea and urinary microalbumin are risk factors for diabetes complicated with diabetic nephropathy and its progression;the glomerular filtration rate is a protective factor.These three indicators have important diagnostic and predictive value for DKD.