2型糖尿病患者肥胖相关指标与糖尿病肾病的关系探讨

The study on the relationship between obesity related indexes and diabetic kidney disease in type 2 diabetes mellitus

目的探讨2型糖尿病患者肥胖相关指标与糖尿病肾病的关系。方法选择870例2型糖尿病患者为研究对象,根据其尿白蛋白与肌酐比值(urinary albumin creatinine ratio,UACR)水平分为糖尿病肾病组(UACR≥30mg/g,共264例)和非糖尿病肾病组(UACR<30mg/g,共606例)。比较两组之间肥胖相关指标的水平,分析2型糖尿病患者肥胖相关指标与糖尿病肾病的关系。结果和非糖尿病肾病组相比,糖尿病肾病组的体重指数(Body mass index,BMI)、腰围(waist circumference,WC)、腰围身高比值(waistto height ratio,WHtR)、腰臀比(waist to hipratio,WHR)、内脏脂肪指数(visceral Fat Index,VFI)、体脂肪率(total body fat percentage,TBF)均高于非糖尿病肾病组,P<0.05;在校正了协变量后,发现BMI在糖尿病肾病组及非糖尿病肾病组之间无统计学差异,P>0.05;而WC、WHtR、WHR、VFI、TBF在两组之间仍具有统计学差异,P<0.05。结论WC、WHtR、WHR、VFI、TBF可能是糖尿病肾病发生、发展的危险因素,尤其是腹型肥胖相关指标为2型糖尿病者发展为糖尿病肾病的重要危险因素。

Objective To explore the relationship between obesity-related indicators and diabetic kidney disease in patients with type 2 diabetes.Method A total of 870 patients with type 2 diabetes were selected as the research objects,according to their urinary albumin to creatinine ratio(urinary albumin creatinine ratio,UACR)levels were divided into diabetic kidney disease group(UACR>3Omg/g,a total of 264 cases)and non-diabetic kidney disease group(UACR<30mg/g,606 cases).Results Compared with the non-diabetic kidney disease group,the diabetic kidney disease group had better body mass index(BMI),waist circumference(WC),waist to height ratio(WHtR),waist to hip ratio(WHR),visceral Fat Index(VFI),and total body fat percentage(TBF)were higher than those in the non-diabetic nephropathy group,P<0.05;after adjusting for covariates,it was found that there was no significant difference in BMI between diabetic kidney disease and non-diabetic kidney disease groups,P>0.05;there were still significant differences in WC,WHtR,WHR,VFI and TBF between the two groups(P<0.05).Conclusions WC,WHtR,WHR,VFI,and TBF may be risk factors for the occurrence and development of diabetic kidney disease,especially abdominal obesity-related indicators are important risk factors for the development of diabetic kidney disease in patients with type 2 diabetes.