老年2型糖尿病患者尿白蛋白排泄率与胰岛素抵抗的相关性研究  

Study on the Correlation Between Different Urinary Albumin Excretion Rate and Insulin Resistance in Elderly Type 2 Diabetes Mellitus

作　　者：黄虹[1] 吴天凤[1] 郑和昕[1] 江缨[1] 袁放[1] 

机构地区：[1]浙江医院,310013

出　　处：《心脑血管病防治》2012年第3期195-197,200,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨老年2型糖尿病患者不同尿白蛋白分期与胰岛素抵抗的关系,为糖尿病肾病的预防与控制提供有益的参考。方法将152例老年2型糖尿病患者根据24小时尿微量白蛋白,分为正常白蛋白尿、微量白蛋白尿和大量白蛋白尿3组,分别测定体质指数、血压、空腹血糖、空腹胰岛素、糖化血红蛋白、血脂、血尿酸、24小时尿白蛋白定量等,并计算胰岛素抵抗指数(HOMA-IR)及估算的肾小球滤过率(eGFR)。结果与正常白蛋白尿组比较,微量白蛋白尿组患者的年龄、高血压合并率、HOMA-IR均明显升高,而eGFR明显下降(P<0.05);大量白蛋白尿组患者的高血压合并率、血压、空腹血糖、空腹胰岛素、总胆固醇、HOMA-IR亦均明显升高,而eGFR明显下降(P<0.05)。与微量白蛋白尿组比较,大量白蛋白尿组患者舒张压、空腹血糖、空腹胰岛素、总胆固醇均明显增高(P<0.05)。多因素逐步回归分析显示HOMA-IR是影响老年2型糖尿病患者尿白蛋白排泄率的独立危险因素。结论老年2型糖尿病患者尿白蛋白增多与胰岛素抵抗有关。Objective To investigate the correlation between different urinary albumin excretion rate and insulin resistance in elderly type 2 diabetes patients.Methods 152 elderly type 2 diabetic patients were recruited in the study,and were divided into three groups：normoalbuminuria group,microalbuminuria group and macroalbuminuria group.Body mass index,blood pressure,fasting plasma glucose,fasting insulin,glycated hemoglobin,lipids,uric acid,24-hour urinary albumin quantification,insulin resistance index HOMA-IR and estimated glomerular filtration rate were measured.Results The age,hypertension rate,HOMA-IR of the patients with microalbuminuria were significantly higher and eGFR was significantly lower compared with the normal albuminuria patients（P〈0.05）.The hypertension rate,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,fasting glucose（FPG）,fasting insulin（FINS）,total cholesterol（TC）,HOMA-IR of the patients with macroalbuminuria were all increased significantly and eGFR decreased significantly compared with the normalalbuminuria patients（P〈0.05）.The DBP,FPG,FINS,TC of patients with macroalbuminuria were significantly higher compared with the patients with microalbuminuria.Multivariate analysis showed that HOMA-IR was an independent risk factor that affect urinary albumin excretion rate in the elderly type 2 diabetic patients.Conclusions Urinary albumin increase is associated with insulin resistance in elderly type 2 diabetic patients.

关 键 词：老年 2型糖尿病 尿白蛋白排泄率 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]