老年2型糖尿病患者尿微量白蛋白升高的危险因素分析

Risk factors of elevated urinary microalbumin in elderly patients with type 2 diabetes mellitus

目的:探讨老年2型糖尿病患者尿微量白蛋白升高的危险因素。方法:对医院2016年7月至2021年10月收治的382例老年2型糖尿病患者的临床资料进行回顾,统计老年2型糖尿病患者发生尿微量白蛋白升高的情况,分为发生者和未发生者;总结可能影响老年2型糖尿病患者尿微量白蛋白升高的相关危险因素并对比发生者和未发生者可能危险因素的构成比;采用Logistic回归分析探讨老年2型糖尿病患者尿微量白蛋白升高的危险因素。结果:本组患者中共有84例发生尿微量白蛋白升高,发生率为21.99%;发生者BMI≥25 kg·m^(-2)、糖尿病病程≥5年,空腹血糖(FBG)不达标,餐后2 h血糖(2 h PBG)不达标,糖化血红蛋白(HbAlc)不达标,胰岛素抵抗指数(HOMA-IR)≥2.77,合并高脂血症、合并高血压、合并冠心病、合并高尿酸血症构成比均高于未发生者(P<0.05);经Logistic回归分析可知,BMI≥25 kg·m^(-2)、糖尿病病程≥5年、血糖控制不达标、HOMA-IR≥2.77、合并高脂血症、合并高血压、合并冠心病和合并高尿酸血症均是老年2型糖尿病患者发生尿微量白蛋白升高的独立危险因素(P<0.05)。结论:老年2型糖尿病患者有尿微量白蛋白升高的风险,BMI≥25 kg·m^(-2)、糖尿病病程≥5年、血糖控制不达标、HOMA-IR≥2.77、合并高脂血症、合并高血压、合并冠心病和合并高尿酸血症均是其危险因素,需加强防控。

Objective:To investigate the risk factors of elevated urinary microalbumin in elderly patients with type 2 diabetes mellitus.Methods:The clinical data of 382 elderly patients with type 2 diabetes mellitus admitted to the hospital from July 2016 to October 2021 were reviewed.The elevation of urinary microalbumin in elderly patients with type 2 diabetes mellitus was analyzed,who were then divided into occurrence of elevated urinary microalbumin and none.The risk factors associated with elevated urinary microalbumin in elderly patients with type 2 diabetes mellitus were summarized and the composition ratio of possible risk factors in elderly patients with and without type 2 diabetes mellitus was compared.Risk factors for elevated urinary microalbumin in elderly patients with type 2 diabetes mellitus were investigated by logistic regression analysis.Results:A total of 84 patients in this group developed elevated urinary microalbumin,with an incidence rate of 21.99%.The patients with BMI≥25 kg·m^(-2),course of diabetes≥5 years,substandard fasting blood glucose(FBG)not up to standard,substandard postprandial blood glucose(2 hPBG),substandard glycosylated hemoglobin(HbAlc),insulin resistance index(HOMA-IR)≥2.77,hyperlipidemia,hypertension,coronary heart disease and hyperuricemia were all higher than those without(P<0.05).Logistic regression analysis showed that BMI≥25 kg·m^(-2),course of diabetes≥5 years,substandard blood glucose,HOMA-IR≥2.77,hyperlipidemia,hypertension,coronary heart disease,hyperuricemia were independent risk factors for the rise of urinary microalbumin in elderly patients with type 2 diabetes mellitus(P<0.05).Conclusion:Elderly patients with type 2 diabetes mellitus have the risk of increasing urinary microalbumin,and BMI≥25 kg·m^(-2),duration of diabetes≥5 years,substandard blood glucose,HOMA-IR≥2.77,combining with hyperlipidemia,hypertension,coronary heart disease and hyperuricemia are the risk factors,which need strengthened prevention and control.