2型糖尿病患者平均血小板体积、纤维蛋白原与尿微量白蛋白与尿肌酐比值的相关性分析

Correlation Analysis of Mean Platelet Volume,Fibrinogen and Ratio of Urinary Microalbumin and Urinary Creatinine in Patients with Type 2 Diabetes Mellitus

目的探讨平均血小板体积(MPV)、纤维蛋白原(FIB)与尿微量白蛋白/尿肌酐比值的相关性。方法选取该院2019年1月—2021年7月就诊的319例2型糖尿病(T2DM)患者作为研究对象,根据尿微量白蛋白与尿肌酐比值(ACR),分为正常白蛋白尿组(NA组ACR<30 mg/g)、微量白蛋白尿组(MIA组,30 mg/g≤ACR<300 mg/g)和大量白蛋白尿组(MA组,ACR>300 mg/g)。采用Pearson检验分析2型糖尿病患者临床资料及生化指标与尿微量白蛋白/尿肌酐的相关性。以2型糖尿病患者ACR为因变量,进行多元Logistic回归,进一步分析2型糖尿病患者ACR升高的影响因素。结果Pearson相关分析显示,ACR与FIB、MPV呈正相关(P<0.05),与NLR无明显相关性(P>0.05)。随着ACR水平升高,NA组、MIA组、MA组的MPV、FIB逐渐升高,MPV(10.69±1.62)、(11.46±1.32)、(12.39±1.23)fL,FIB(4.32±1.70)、(4.99±1.74)、(5.95±1.80)g/L,差异有统计学意义(P<0.05)。多元Logistic回归分析显示,在校正性别、年龄、糖尿病病程、吸烟史、饮酒史、高血压病史等因素后,FIB(OR=0.481,95%CI=0.154~0.808,P<0.05)是2型糖尿病患者尿微量白蛋白/尿肌酐比值增加的独立影响因素。结论MPV、FIB的升高与2型糖尿病尿微量白蛋白/尿肌酐比值有关,FIB可能是预测2型糖尿病早期肾损伤程度指标之一。

Objective To investigate the correlation between mean platelet volume(MPV),fibrinogen(FIB)and urinary microalbumin/urine creatinine ratio.Methods 319 patients with type 2 diabetes mellitus(T2DM)who visited the hospital from January 2019 to July 2021 were selected as the research subjects.According to the urinary microalbumin to urinary creatinine ratio(ACR)was divided into normoalbuminuria group(NA group,ACR<30 mg/g),microalbuminuria group(MIA group,30 mg/g≤ACR<300 mg/g)and macroalbuminuria group(MA group,ACR>300 mg/g).The Pearson test was used to analyze the correlation of clinical data and biochemical indexes with urinary microalbumin/urine creatinine in patients with type 2 diabetes.Using ACR in patients with type 2 diabetes as the dependent variable,multivariate Logistic regression was performed to further analyze the influencing factors of ACR increase in patients with type 2 diabetes.Results Pearson correlation analysis showed that ACR was positively correlated with FIB and MPV(P<0.05),but had no significant correlation with NLR(P>0.05).With the increase of ACR level,MPV and FIB of NA group,MIA group and MA group gradually increased,MPV(10.69±1.62)fL,(11.46±1.32)fL,(12.39±1.23)fL,FIB(4.32±1.70)g/L,(4.99±1.74)g/L,(5.95±1.8)g/L,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that after adjusting for gender,age,duration of diabetes,history of smoking,drinking,history of hypertension and other factors,FIB(OR=0.481,95%CI=0.154~0.808,P<0.05)was an independent influencing factor for increased urinary microalbumin/urine creatinine ratio in patients with type 2 diabetes.Conclusion The increase of MPV and FIB is related to the ratio of urinary microalbumin/urine creatinine in type 2 diabetes.FIB may be one of the indicators to predict the degree of early renal damage in type 2 diabetes.