2型糖尿病患者尿钙肌酐比值与24小时尿钙相关性研究

Correlation between urinary calcium creatinine ratio and 24-hour urinary calcium in type 2 diabetes mellitus

目的通过测定不同时间点尿钙肌酐比值评价糖尿病患者24 h尿钙(24 h UCa),探讨尿钙肌酐比值指标是否适用于糖尿病患者的24 h UCa评价。方法选择2020年9月至2021年1月天津医科大学朱宪彝纪念医院内分泌科2型糖尿病患者,收集每位患者入院后第3 d空腹、早餐后2 h及睡前的尿标本、24 h尿样本各1份,最终尿钙资料收集齐全者175例,分别检测并记录空腹、早餐后2 h及睡前尿钙及尿肌酐浓度、24 h UCa排出量、24 h尿量,计算空腹、早餐后2 h及睡前尿钙与尿肌酐比值,评价2型糖尿病患者尿钙肌酐校正方法。结果入院后早餐后2 h尿钙肌酐比值与实际的24 h UCa排出量呈中等程度相关性(r=0.558,P<0.0001),睡前、空腹尿钙肌酐比值与实际的24 h UCa排出量呈较强的相关性(r=0.716、r=0.601,P均<0.0001),年龄及病程分组中,年龄≥70岁,病程≥10年的24 h UCa排泄量与尿钙肌酐比值之间相关性较强,尿糖与尿钙排泄无相关性。结论睡前及空腹尿钙肌酐比值与实际的24 h UCa排出量相关性较强,可作为糖尿病患者24 h UCa状态的初筛指标,其中年龄≥70岁,病程≥10年患者的24 h UCa排泄量与尿钙肌酐比值之间相关性较强,未发现尿糖变化对尿钙排泄的影响。

Objectives To evaluate 24-hour urinary calcium in diabetic patients by measuring the urinary calcium creatinine ratio at different time points,and to explore whether the urinary calcium creatinine ratio index is suitable for 24-hour urinary calcium evaluation in diabetic patients.Methods Patients with type 2 diabetes were selected from the Endocrinology Department of Zhuxian Yi Memorial Hospital of Tianjin Medical University from September 2020 to January 2021.Urine samples of each patient on fasting,2 h after breakfast and 24 hours before bed on the third day after admission were collected,and 175 patients with complete urinary calcium data were finally collected.Fasting,2 h after breakfast and before bed urinary calcium and creatinine concentrations,24-hour urinary calcium output and 24-hour urinary volume were detected and recorded,respectively.The ratio of fasting,2 h after breakfast and before bed urinary calcium to urinary creatinine was calculated,and the correction method for urinary calcium creatinine in type 2 diabetes patients was evaluated.Results After admission,the urinary calcium creatinine ratio at 2 h after breakfast was moderately correlated with the actual 24-hour urinary calcium output(r=0.558,P<0.0001),and the fasting urinary calcium creatinine ratio at bedtime was strongly correlated with the actual 24-hour urinary calcium output(r=0.716,r=0.601,both P<0.0001).In age and disease course groups,24-hour calcium excretion with age≥70 years and disease course≥10 years was strongly correlated with urinary creatinine ratio.There was no correlation between urinary sugar and urinary calcium excretion.Conclusion In this study,there was a strong correlation between the ratio of calcium creatinine at bedtime and fasting urine and the actual 24-hour urinary calcium excretion,which could be used as the preliminary screening index of 24-hour urinary calcium status in diabetic patients.In patients aged≥70 years and with a course of disease≥10 years,there was a strong correlation between 24-hour urinary calcium excretion and urinary creatinine ratio,and no influence of changes in urinary sugar on urinary calcium excretion was found.