2型糖尿病患者血糖水平与肾功能损伤的关系  

The relationship between renal function and blood glucose levels in patients with type 2 diabetes

作　　者：庄兴[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院检验科,上海200011

出　　处：《国际检验医学杂志》2013年第16期2109-2110,共2页International Journal of Laboratory Medicine

摘　　要：目的探讨2型糖尿病患者血糖水平与肾功能损伤的关系。方法检测了225例2型糖尿病患者的血清肌酐(SCr)和空腹血糖(FPG)、餐后2h血糖(PPG),收集24h尿液进行尿肌酐(UCr)、微量清蛋白(mALB)、β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、转铁蛋白(TRF)、总蛋白(TPro)检测。根据rMDRD、CKD-EPI公式计算得到的eGFR值将患者分为肾功能正常组、轻中度损伤组和重度损伤组,观察尿TRF、mALB、β2-MG、NAG和TPro及FPG和PPG水平与肾功能损伤的关系。根据FPG、PPG水平对患者进行分组,观察血糖水平与尿蛋白标志物的关系。结果根据两个预估公式计算的GFR进行的分组有明显差异(P=0.000);NAG、mALB、β2-MG、TRF、TPro与UCr的比值在三组间差异有统计学意义(P<0.05)。以FPG大于6.1mmol/L为界限,mALB、β2-MG、TRF、NAG、TPro与UCr比值的ROC下的面积分别为0.644、0.500、0.632、0.506、0.568。结论 2型糖尿病患者尿液蛋白标志物mALB、TRF、TPro、β2-MG、NAG是表示肾功能损伤程度的优化指标,其中尿mALB、TRF还可用于血糖控制效果的监测。但FPG水平和肾功能损伤程度并没有直接联系。Objective To study the relationship between blood glucose levels and kidney function impairment in patients with type 2 diabetes.Methods A total of 225 patients with type 2 diabetes were enrolled in this study,whose SCr,FPG,PPG,Ucr,mALB,β2-MG,NAG,TRF,TPro were measured.Statistical analysis of the test data was performed according to eGFR which was calculated with rMDRD and CKD-EPI formulas,FPG,PPG.According to the the eGFR calculated by different formulas,patients were divided into normal renal function group,mild-to-moderate and severe renal impairment group.Results Two grouping methods were significantly different（P=0.000）;Compared among the three groups NAG,mALB,β2-MG,TRF,TPro/UCr ratios were statistically different（P＆lt;0.05）.Use FPG＆gt;6.1 mmol /L as the cut-off value,the area under the ROC of mALB,β2-MG,TRF,NAG,TPro/UCr ratios were 0.644,0.500,0.632,0.506,0.568,respectively.Conclusion Urine protein marks such as mALB,TRF,β2-MG,NAG,TPro can be used as indicators of renal impairment of different degrees in patients with type 2 diabetes.Especially,urine mALB、TRF can be used to monitor the effects of glucose control,but no direct relationship is found between FPG and the degree of renal impairment degree.

关 键 词：血糖 微量清蛋白 转铁蛋白 乙酰氨基葡糖苷酶 Β2微球蛋白 肾小球滤过率 

分 类 号：R587.1[医药卫生—内分泌]