身体质量指数对2型糖尿病肾病的影响

Effect of body mass index on type 2 diabetic nephropathy

目的探讨身体质量指数(BMI)对2型糖尿病肾病(T2DN)的影响。方法选取2019年1~12月在北部战区总医院内分泌科住院治疗且临床资料相对完整符合入选条件的422例2型糖尿病(T2DM)患者作为研究对象,按其BMI的不同,分成体质量正常组(n=106)、体质量超重组(n=169)和体质量肥胖组(n=147);按其是否合并糖尿病肾病(DN),分为合并肾病组(n=95)和未合并肾病组(n=327)。回顾性分析患者的一般临床资料、生化指标及DN的发病情况。结果BMI不同的3组患者年龄、收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、血清肌酐(SCr)及DN发生率等差异均有统计学意义(P<0.05);3组之间两两比较:体质量超重组和体质量肥胖组患者的SBP、DBP、TG、UA、SCr及DN发生率均高于体质量正常组,HDL-C均低于体质量正常组,差异均有统计学意义(P<0.05);体质量肥胖组的年龄与体质量正常组之间的差异有统计学意义(P<0.05);二分类多因素logistic回归分析显示:BMI(OR=1.158,95%CI:1.036~1.295)、TC(OR=1.385,95%CI:1.007~1.903)和SCr(OR=1.060,95%CI:1.047~1.072)是DN发生的危险因素。结论BMI与T2DM患者并发DN的关系较为密切,应关注患者BMI的变化,并引导患者合理膳食和适当运动,将BMI控制在正常范围内。

Objective To investigate the effect of body mass index(BMI)on type 2 diabetic nephropathy(T2DN).Methods A total of 422 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the Department of Endocrinology at the General Hospital of Theater Command from January 2019 to December 2019 and whose clinical data were relatively complete and eligible for enrollment were selected for the study.According to BMI,they were divided into normal body mass group(n=106),overweight group(n=169)and obese body mass group(n=147);according to whether they had combined diabetic nephropathy,they were divided into combined nephropathy group(n=95)and uncomplicated nephropathy group(n=327).The patients’general clinical data,biochemical parameters and the onset of DN were retrospectively analyzed.Results The comparison of clinical indicators between the three groups with different BMI showed that there were significant differences in the age,systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),uric acid(UA),serum creatinine(SCr)and the incidence of DN(P<0.05).Pairwise comparison among the three groups showed that there were significant differences in the SBP,DBP,TG,UA,SCr,and the incidence of DN was higher in the overweight and obese body mass groups than in the normal body mass group,and HDL-C was lower than thatof the normal body mass group(P<0.05).There was significant difference in the age between the body mass obese group and the body mass normal group.Binary multivariate Logistic regression analysis indicated that BMI(OR=1.158,95%CI:1.036~1.295),TC(OR=1.385,95%CI:1.007~1.903)and SCr(OR=1.060,95%CI:1.047~1.072)were risk factors for DN.Conclusions BMI is closely related to diabetic nephropathy in T2DM.In order to keep BMI in the normal range,more attention should be paid,measures such as reasonable diet and proper exercise should be advocated.