2型糖尿病患者血清胆红素水平与糖尿病肾病关系的研究  

Relationship between serum bilirubin and diabetic kideny disease in patients with type 2 diabetes

作　　者：陈宇[1] 周永华[1] 韩晓骏[1] 严冲[1] 苏如婷[1] 李小飞[1] 

机构地区：[1]南通大学附属海安医院肾脏内科,江苏南通226600

出　　处：《临床荟萃》2011年第4期292-295,共4页Clinical Focus

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清胆红素水平与糖尿病肾病(diabetic kidney disease,DKD)之间的关系。方法 789例T2DM患者,按照24小时尿白蛋白定量分为正常尿白蛋白组(尿白蛋白<30 mg)、微量尿白蛋白组(尿白蛋白30～300 mg)和临床尿白蛋白组(尿白蛋白>300 mg),并以168例正常成人作为对照组,观察各组之间血清胆红素的差异,探讨血清胆红素水平与DKD的关系。结果 T2DM患者血清总胆红素、直接胆红素和间接胆红素水平均低于正常对照组(P<0.01或<0.05)。微量尿白蛋白组的总胆红素和间接胆红素均较正常尿白蛋白组下降(P<0.01或<0.05),而直接胆红素差异无统计学意义(P>0.05);临床尿白蛋白组的总胆红素、直接胆红素以及间接胆红素均低于其他两组(P<0.01)。将尿白蛋白与血清胆红素水平作相关性分析,结果显示尿白蛋白与总胆红素、直接胆红素、间接胆红素的相关系数分别为r=-0.108,P<0.01;r=-0.068,P>0.05;r=-0.106,P<0.05。3组患者的肾小球滤过率与总胆红素、直接胆红素、间接胆红素的相关性分别为r=0.196,P<0.01;r=0.074,P>0.05;r=0.12,P<0.05。结论胆红素可能是T2DM患者肾脏的保护性因子。糖尿病早期采取积极的抗氧化治疗对防止DKD的发生发展有重要意义。Objective To approach the relationship between serum bilirubin level and diabetic kideny disease in patients with type 2 diabetes mellitus（T2DM）.Methods 789 T2DM patients were classified into normoalbuminuria group（urinary albumin excretion less than 30 mg per 24 h）,microalbuminuria group（urinary albumin excretion range from 30 to 300 mg per 24 h） and macroalbuminuria group（urinary albumin excretion more than 300 mg per 24 h） according to the degree of urinary albumin excretion.We chose 168 healthy adults randomly as the control group.The difference in serum bilirubin among groups and the correlation between serum bilirubin and diabetic nephropathy were analyzed.Results T2DM group had higher levels of serum total bilirubin,direct bilirubin and unconjugated bilirubin significantly than those of the control group（P0.01 or P0.05）.The total bilirubin and unconjugated bilirubin levels of the microalbuminuria group were lower compared with those of the normoalbuminuria group（P0.01,P0.05）,while there was no significant difference in the direct bilirubin（P0.05）.Compared with the other two groups,the macroalbuminuria group had lower serum total bilirubin,direct bilirubin as well as unconjugated bilirubin,difference was significant（P0.01）.The correlation analysis showed that the correlation coefficients of urinary albumin to serum total bilirubin,direct bilirubin and unconjugated bilirubin were r=-0.108,P0.01,r=-0.068,P0.05,r=-0.106,P0.05,respectively.Besides,we found that the correlation coefficients of glomerular filtration rate to serum total bilirubin,direct bilirubin and unconjugated bilirubin were r=0.196,P0.001,r=0.074,P0.05,r=0.12,P0.05,respectively.Conclusion Bilirubin may be a protective factor of the kidneys in patients with T2DM.It is very important to take active antioxidant treatments in early stage of T2DM to prevent the development of diabetic kidney disease.

关 键 词：糖尿病 2型 糖尿病肾病 胆红素 尿白蛋白 

分 类 号：R587.1[医药卫生—内分泌]