老年2型糖尿病病人糖尿病足风险评分与尿微量白蛋白/肌酐的相关性分析

Correlation between diabetic foot risk score and urinary microalbumin/creatinine ratio in elderly patients with type 2 diabetes

目的 分析老年T2DM人群糖尿病足风险评分与尿微量白蛋白/肌酐(UMCR)之间的相关性。方法 选取2018年1月至2021年12月在我院内分泌科住院的老年T2DM病人321例,根据Gavin’s足危险因素加权值积分分为低危足组和中高危足组,观察并比较2组一般资料及相关代谢指标。采用多因素Logistic回归分析糖尿病中高危足的影响因素,绘制ROC曲线,分析UMCR对糖尿病中高危足风险的预测价值。结果 2组年龄、性别、居住状况、糖尿病病程、腰围及HbA1c、HDL-C、双下肢踝臂指数、UA、UMCR、估算的肾小球滤过率(eGFR)、血肌酐、BUN水平差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果提示,UMCR(OR=1.002,95%CI:1.001~1.004,P<0.05)是T2DM病人发生糖尿病中高危足的影响因素。ROC曲线分析显示,UMCR预测糖尿病中高危足的AUC为0.739,特异度为78.6%,敏感度为62.0%,截断值为43.23 mg/g。结论 UMCR与糖尿病足风险评分密切相关,对糖尿病中高危足风险具有良好的预测价值。

Objective To analyze the correlation between diabetic foot risk score and urinary microalbumin/creatinine ratio(UMCR)in the elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 321 elderly patients with T2DM admitted to Department of Endocrinology of our hospital from January 2018 to December 2021 were enrolled in this study.According to the Gavin’s foot risk factor weighted score,all patients were divided into the low risk foot group and the medium-high risk foot group.The general data and metabolic indexes of the patients were observed and compared.Multivariate Logistic regression analysis was used to analyze the influencing factors for medium-high risk foot,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of UMCR for medium-high risk foot.Results There were significant differences in age,gender,living status,diabetes course,waist circumference,the levels of glycosylated hemoglobin(HbA1c),high-density lipoprotein cholesterol(HDL-C),ankle brachial index(ABI),serum uric acid(UA),UMCR,estimated glomerular filtration rate(eGFR),serum creatinine(Scr)and blood urine nitrogen(BUN)between the two groups(P<0.05).Multivariate Logistic regression analysis showed that UMCR was the risk factor for medium-high risk foot in the elderly T2DM patients(OR=1.002,95%CI:1.001-1.004,P<0.05).ROC curve showed that the area under the curve of UMCR in predicting medium-high risk foot was 0.739,the specificity was 78.6%,the sensitivity was 62.0%and the cut-off value was 43.23 mg/g.Conclusions UMCR is closely related to diabetic foot risk score,and has good predictive value for diabetic foot risk.