2型糖尿病患者糖化血红蛋白、尿微量白蛋白、空腹血糖与糖尿病肾病的相关性分析

Correlation of Glycated Haemoglobin,Urinary Microalbumin,Fasting Plasma Glucose and Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

目的:分析2型糖尿病患者糖化血红蛋白(HbA1c)、尿微量白蛋白(MAU)、空腹血糖(FPG)与糖尿病肾病的相关性。方法:纳入2020年5月—2022年3月在厦门大学附属第一医院接受诊治的126例糖尿病肾病患者为观察组,同期纳入在本院接受体检的126例健康志愿者为对照1组,以及在本院接受诊治126例无糖尿病肾病的2型糖尿病患者作为对照2组;并将观察组患者根据病情严重程度分为Ⅰ~Ⅴ期。比较三组研究对象和观察组不同分期患者的HbA1c、MAU和FPG指标水平,对HbA1c、MAU和FPG与糖尿病肾病及其病情分期的相关性进行分析。结果:观察组的HbA1c和FPG最高,其次是对照2组,对照1组最低,三组HbA1c和FPG比较,差异有统计意义(P<0.05);对照1组和对照2组的MAU比较,差异无统计学意义(P>0.05);观察组的MAU分别高于对照1组和对照2组,差异有统计学意义(P<0.05)。Ⅰ期和Ⅱ期的HbA1c比较,差异无统计学意义(P>0.05),Ⅴ期的HbA1c最高,其次是Ⅳ期、Ⅲ期,Ⅱ期最低,Ⅰ~Ⅴ期的HbA1c比较,差异有统计学意义(P<0.05);Ⅴ期的MAU和FPG最高,其次是Ⅳ期、Ⅲ期、Ⅱ期,Ⅰ期最低,Ⅰ~Ⅴ期的MAU和FPG比较,差异有统计学意义(P<0.05)。经Spearman法进行相关性分析发现,糖尿病肾病发生和疾病分期与HbA1c、MAU和FPG呈正相关(r_(s)>0,P<0.05)。结论:糖尿病肾病患者的HbA1c、MAU和FPG指标水平高于未合并糖尿病肾病的2型糖尿病患者和健康人群,病情越严重,HbA1c、MAU和FPG指标水平升高越明显,且HbA1c、MAU和FPG与糖尿病肾病的发生和进展密切相关。

Objective:To analyse the correlation between glycated haemoglobin(HbA1c),urinary microalbumin(MAU),fasting plasma glucose(FPG)and diabetic nephropathy in patients with type 2 diabetes mellitus.Method:A total of 126 patients with diabetic nephropathy treated in the First Affiliated Hospital of Xiamen University from May 2020 to March 2022 were included as the observation group,at the same time,126 healthy volunteers who underwent physical examination in our hospital were included as the control group 1,and 126 patients with type 2 diabetes mellitus without diabetic nephropathy treated in our hospital were included as the control group 2.The observation group was divided into stageⅠtoⅤaccording to the severity of the disease.The levels of HbA1c,MAU and FPG indexes were compared between the three groups of subjects and the observation group at different stages,and the correlation between HbA1c,MAU and FPG and the occurrence and stage of glycosuric nephropathy was analyzed.Result:The HbA1c and FPG levels in the observation group were the highest,followed by the control group 2 and the control group 1,and the differences of HbA1c and FPG levels in the three groups were statistically significant(P<0.05).There was no significant difference in MAU between control group 1 and control group 2(P>0.05).The MAU of observation group was higher than that of control group 1 and control group 2,respectively,and the differences were statistically significant(P<0.05).There was no statistically significant difference in HbA1c between stageⅠand stageⅡ(P>0.05),and HbA1c in stageⅤwas the highest,followed by stageⅣand stageⅢ,and stageⅡwas the lowest,and there was statistically significant difference in HbA1c of stageⅠto stageⅤ(P<0.05).The MAU and FPG of stageⅤwere the highest,followed by stageⅣ,ⅢandⅡ,and stageⅠwas the lowest,and the differences in MAU and FPG of stageⅠtoⅤwas statistically significant(P<0.05).Correlation analysis by Spearman method showed that the occurrence and stage of diabetes nephropathy were positively correlated with HbA1c,MAU and FPG(r_(s)>0,P<0.05).Conclusion:The levels of HbA1c,MAU and FPG indexes in diabetic nephropathy patients were higher than those in type 2 diabetes mellitus without diabetic nephropathy patients and healthy people.The levels of HbA1c,MAU and FPG increased significantly with more severe disease.HbA1c,MAU and FPG were closely related to the occurrence and progression of diabetic nephropathy.