初诊2型糖尿病微量蛋白尿与血管内皮功能的关系  

Association between micro-albuminuria and endothelial dysfunction in newly diagnosed type 2 diabetes mellitus patients

作　　者：谭兴容[1] 石绍川[2] 王毅[1] 鄢立辉[1] 熊艳[1] 朱承娟[1] 

机构地区：[1]重庆市第九人民医院内分泌科,400700 [2]第三军医大学新桥医院检验科,重庆400037

出　　处：《重庆医学》2009年第18期2269-2270,2272,共3页Chongqing medicine

摘　　要：目的探讨初诊2型糖尿病患者微量蛋白尿与血管内皮功能的关系。方法按尿清蛋白排泄量（UAER）将初诊2型糖尿病患者分为对照组（UAER〈20〈μg／min）及微量清蛋白尿组（MA组，UAER为20～200μg／min），采集清晨空腹静脉血测定空腹血糖（FPG）、糖化血红蛋白（HbA1C）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDLC）、低密度脂蛋白胆固醇（LDL—C）、超敏C-反应蛋白（hs-CRP）、丙二醛（MDA）、可溶性血管细胞黏附因子1（sVCAM-1）以及口服葡萄糖耐量2h血糖（2hPG），并留取24h尿检测尿清蛋白含量计算UAER。结果（1）MA组UAER及血清FPG、2hPG、HbA1C、MDA、hsCRP、sVCAM-1呈明显高于对照组。（2）多因素逐步回归分析示UAER与hsCRP、sVCAM-1呈明显正相关（r分别为0．420、0．221，均P〈0．01，n=156）。结论伴有微量蛋白尿的初诊2型糖尿病患者存在血管内皮功能异常，UAER升高的程度可反映血管内皮功能障碍的程度。Objective To investigate the relationship between the urinary albumin excretion rate and the endothelial dysfunction in newly diagnosed type 2 diabetes mellitus patients. Methods Newly diagnosed type 2 diabetes mellitus patients were divided into two groups：the control group（n=76,UAER〈20μg/min）and the MA group（n 80,UAER 20-200μg/min）. All patients were re cruited. Fasting glucose（ FPG）, glycosylated hemoglobin （ HbA1c）, triglycerides （TG）, high density liproprotein-cholesterol （ HDL-C） ,low density liproprotein cholesterol （LDL-C）, high sensitive C-reactive protein （hs-CRP）, maleic dialdehyde （MDA）, soluble vascular cell adhesion molecule-1（sVCAM-1）were measured after 12 h overnight fast and 2h plasma glucose during oral glucose tolerance test（2hPG） were determined,also the levels of 24h microalbuminuria were determined. Results （1）Urinary albumin excretion rate（UAER）, FPG, 2hPG, HbA1c, MDA, hsCRP, sVCAM-lwere signifieanfly higher in the MA group than those in the control group（P〈0.05 or P〈0.01）. （2）Stepwise regression analysis showed that UAER was positively related to hs-CRP,sVCAM-1 （r =0. 420,0. 221,both P〈0.01,n= 156）. Conclusion Newly diagnosed type 2 diabetes mellitus patients with MA have more remarkable endothelial dysfunction than those without MA. The increase of UAER is correlated with the degree of endothelial dysfunetion.

关 键 词：微量清蛋白尿 内皮 血管 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R446.113[医药卫生—内科学]