2型糖尿病患者血清胆红素、血脂与糖尿病肾病的关系初探  

Relationship between serum bilirubin,lipid and diabetic kidney disease in patients with type 2 diabetes mellitus

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

机构地区：[1]南通大学附属海安医院内分泌科,海安226600

出　　处：《南通大学学报（医学版）》2013年第3期175-178,共4页Journal of Nantong University(Medical sciences)

摘　　要：目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清胆红素及血脂水平与糖尿病肾病(diabetickidney disease,DKD)发生之间的关系。方法:913例T2DM患者,根据微量白蛋白尿的有无,分为非DKD组和DKD组,并以184例正常成人作为对照组,观察DKD的患病率,各组血清胆红素及血脂的差异,并对DKD发生的危险因素进行多因素Logistic回归分析。结果:T2DM患者DKD的患病率为35.71%(326/913)。DKD组的血清总胆红素、直接胆红素和间接胆红素均明显低于非DKD组(P<0.01或P<0.05)。DKD组的低密度脂蛋白(low density lipoprotein,LDL)明显高于非DKD组(P<0.01),而三酰甘油(triglyceride,TG)、总胆固醇(cholesterol total,TC)、高密度脂蛋白(high density lipoprotein,HDL)DKD组与非DKD组相比,差异无统计学意义(P>0.05)。对DKD的危险因素进行Logistic逐步回归分析,结果显示,年龄、收缩压、TG、LDL和糖尿病病程为T2DM患者DKD发生的独立危险因素(P<0.01或P<0.05),而间接胆红素为DKD的保护性因子(P<0.01)。相关性分析显示LDL与间接胆红素呈负相关(r=-0.146,P<0.01)。结论:糖尿病早期采取积极的抗氧化与调脂治疗对防止DKD的发生有重要意义,且抗氧化与调脂治疗互为有利。Objective： To explore the relationship between serum bilirubin,lipid and diabetic kidney disease（DKD） in patients with type 2 diabetes mellitus（T2DM）.Methods： 913 T2DM patients were divided into DKD group and non-DKD group according to the occurrence of albuminuria.184 healthy adults were chosen randomly as the control group.We observed the prevalence of DKD as well as the difference of serum bilirubin and lipid among all the groups.Multiple logistic regression analyses was used to evaluate the risk factors of DKD.Results： The prevalence of DKD was 35.71%（326/913）.The serum total bilirubin,direct bilirubin and unconjugated bilirubin levels were significantly lower in DKD group（P0.01 or P0.05）.Compared with the non-DKD group,LDL level was significantly higher in the DKD group（P0.01）,while the differences of TC,TG and HDL between the two groups were not significant（P0.05）.Multiple logistic regression analyses revealed that age,systolic blood pressure,serum triglyceride,low density lipoprotein and duration of diabetes were independent risk factors of DKD in T2DM（P0.01 or P0.05）,while unconjugated bilirubin was a protective factor（P0.01）.The correlation analysis showed that the correlation coefficients of unconjugated bilirubin to LDL was r=-0.146,P0.01.Conclusion： It’s very important to take active antioxidant treatments and regulate lipids in early stage of T2DM to prevent the development of DKD,the two therapies were benefit for each other.

关 键 词：2型糖尿病 糖尿病肾病 胆红素 血脂 氧化应激 

分 类 号：R587.1[医药卫生—内分泌]