2型糖尿病患者血清白蛋白和肾功能的相关性分析

Correlation analysis of serum albumin and renal function in patients with type 2 diabetes

目的 分析2型糖尿病患者血清白蛋白和肾功能的相关性,以期早期识别并预防糖尿病患者肾损伤的发生。方法 收集2型糖尿病患者血清白蛋白、血肌酐和24 h尿微量蛋白水平,分为糖尿病肾病中、重度肾损伤组(n=22)和正常或轻度肾损伤组(n=140),分析血清白蛋白和肾功能的相关性。结果 血清白蛋白与肾小球滤过率(eGFR)呈正相关(r=0.348,P<0.05),与24 h尿微量蛋白呈负相关(r=-0.234,P<0.05);与低蛋白血症组相比,血清白蛋白正常组eGFR较高,24 h尿微量蛋白水平较低。进一步单因素分析不同血清白蛋白组间(三分位数分组)肾功能差异发现,eGFR随血清白蛋白增加呈上升趋势(F=9.305,P<0.05),24 h尿微量蛋白呈下降趋势(F=3.142,P<0.05);二分类Logistic回归分析结果显示,随着血清白蛋白的增加,糖尿病中、重度肾损伤的发生率降低(χ^(2)=38.806,P<0.05)。结论 2型糖尿病患者血清白蛋白和肾功能存在相关性,且患者中、重度肾损伤的发生率随血清白蛋白水平的增加而降低。临床低血清白蛋白水平的糖尿病患者需警惕肾损伤的发生。

Objective To analyze the correlation between serum albumin and renal function in patients with type 2 diabetes so as to identify and prevent renal injury in patients with diabetes early.Methods The serum albumin,serum creatinine and 24-hour urine microprotein levels of patients with type 2 diabetes were collected.They were divided into moderate or severe renal injury group(n=22) and normal or mild renal injury group(n=140) in diabetes nephropathy.The correlation between serum albumin and renal function were analyzed.Results Serum albumin was positively correlated with glomerular filtration rate(eGFR)(r=0.348,P<0.05),and negatively correlated with 24 h-urinary microprotein(r=-0.234,P<0.05).Compared with the hypoproteinemia group,the eGFR of the normal serum albumin group was higher,and the 24 h urine microprotein level was lower.Further univariate analysis of renal function differences between different serum albumin groups(three quantile grouping) showed that eGFR increased with the increase of serum albumin(F=9.305,P<0.05),and 24 h urine microprotein decreased(F=3.142,P<0.05).The results of binary logistic regression analysis showed that with the increase of serum albumin,the incidence of moderate and severe renal injury in diabetes decreased(χ^(2)=38.806,P<0.05).Conclusions There is a correlation between serum albumin and renal function in patients with type 2 diabetes,and the incidence of moderate and severe renal injury decreases with the increase of serum albumin level.Diabetes patients with low serum albumin level should be alert to kidney injury.