老年2型糖尿病患者尿微量白蛋白与纤维蛋白原的相关性

Correlation between urinary albumin and fibrinogen in elderly patients with type 2 diabetes mellitus

目的探究老年2型糖尿病患者尿微量白蛋白与纤维蛋白原的相关性。方法前瞻性收集2020年1月至2021年1月入上海市杨浦区中心医院接受治疗的2型糖尿病患者146例,按照尿微量白蛋白(UMA)的含量将其分为UMA正常组(UMA≤30 mg/d,n=75)和UMA异常组(UMA>30 mg/d,n=71)。收集患者的临床资料,并进行实验室相关指标检测进行对比分析,尿微量白蛋白与纤维蛋白原的相关性采用Pearson相关分析,应用多元线性回归分析影响因素。结果两组患者的性别构成比、年龄、体重指数、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、舒张压相比,差异均无统计学意义(P>0.05);UMA异常组中糖尿病病程、超敏C反应蛋白、糖化血红蛋白、空腹血糖、尿素氮、血肌酐、尿酸、收缩压、尿白蛋白/肌酐比值(UACR)和纤维蛋白原水平均明显高于UMA正常组,差异均有统计学意义(P<0.05)。尿微量白蛋白与性别、年龄、体重指数、总胆固醇、甘油三酯、HDL-C、LDL-C、舒张压无相关性(P>0.05),与糖尿病病程、超敏C反应蛋白、糖化血红蛋白、空腹血糖、尿素氮、血肌酐、尿酸、收缩压、UACR和纤维蛋白原呈正相关(P<0.05);糖尿病病程、超敏C反应蛋白、糖化血红蛋白、空腹血糖、尿素氮、血肌酐、尿酸、收缩压、UACR和纤维蛋白原是影响老年2型糖尿病患者UMA水平的独立危险因素(P<0.05)。结论UMA异常的老年2型糖尿病患者纤维蛋白原明显升高,且尿液中UMA水平与UACR和纤维蛋白原呈正相关。

Objective To explore the correlation between urine microalbumin and fibrinogen in elderly patients with type 2 diabetes mellitus.Methods One hundred and forty-six patients with type 2 diabetes mellitus treated in Yangpu District Central Hospital from January 2020 to January 2021 were prospectively collected.According to the content of urinary microalbumin(UMA),they were divided into UMA normal group(UMA≤30 mg/d,n=75)and UMA abnormal group(UMA>30 mg/d,n=71).The clinical data of the patients were collected,and laboratory related indexes were detected for comparative analysis.The correlation between urinary microalbumin and fibrinogen was analyzed by Pearson correlation and multiple linear regression.Results There was no statistically significant difference in sex composition ratio,age,body mass index,total cholesterol,triglyceride,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and diastolic blood pressure between the two groups(P>0.05).In the UMA abnormal group,the duration of diabetes,hypersensitivity C reactive protein,glycosylated hemoglobin,fasting blood glucose,urea nitrogen,serum creatinine,uric acid,systolic blood pressure,urinary albumin/creatinine ratio(UACR)and fibrinogen water were obviously higher than those of UMA normal group,the differences were statistically significant(P<0.05).Urine albumin was not related to gender,age,body mass index,total cholesterol,glycerol three fat,HDL-C,LDL-C,diastolic blood pressure(P>0.05),and positively correlated with the duration of diabetes,hypersensitive C reactive protein,glycosylated hemoglobin,fasting blood glucose,urea nitrogen,serum creatinine,uric acid,systolic blood pressure,UACR and fibrinogen(P<0.05).The course of diabetes,high-sensitivity C-reactive protein,glycosylated hemoglobin,fasting blood glucose,urea nitrogen,blood creatinine,uric acid,systolic blood pressure,UACR and fibrinogen are independent risk factors affecting the level of UMA in elderly patients with type 2 diabetes mellitus(P<0.05).Conclusion Fibrinogen was significantly increased in elderly patients with UMA abnormal type 2 diabetes mellitus and the level of UMA in urine was positively correlated with UACR and fibrinogen.