血浆乳酸在糖尿病患者脂代谢异常及肾功能中的评估价值  

The Value of Blood Lactate Level in Evaluating Lipid Metabolism and Renal Runction in Type 2 Diabetes Patients

作　　者：尤强[1] 董砚虎[2] 王凯[2] 王慧[2] 白路[2] 

机构地区：[1]潍坊医学院内科学教研室,山东潍坊261053 [2]青岛内分泌糖尿病医院

出　　处：《潍坊医学院学报》2016年第2期132-134,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨2型糖尿病(T2DM)合并高乳酸血症状态下机体脂代谢水平、肾功能、肾小球滤过率(GFR)、肌酐清除率(Ccr)、尿微量白蛋白(M-ALB)等变化。方法选取2型糖尿病患者100例,将其分为2型糖尿病高乳酸组和2型糖尿病乳酸正常组,测定所有研究对象的身高(H)、体重(W)、体重指数(BMI)、腰围(WC)、臀围(HC)、腰身比(WSR)、腰臀比(WHR)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、肌酐(CR)、尿素氮(BUN)、肾小球滤过率(GFR)、肌酐清除率(Ccr)、24h尿微量白蛋白等临床资料及生化指标。结果 1糖尿病高乳酸组患者CR,TG,WSR,24h尿微量白蛋白水平明显高于糖尿病乳酸正常组(P<0.05),而GFR,Ccr低于糖尿病乳酸正常组(P<0.05),两组BMI,WC,HC,WHR,FPG,Hb A1c,TC,LDL,BUN等无明显统计学差异(P>0.05)。2应用Pearson相关性分析提示:血乳酸水平与Cr(r=0.354,P<0.001)呈正相关,与HDL(r=-0.260,P<0.05)、GFR(r=-0.287,P<0.05)及Ccr(r=-0.205,P<0.05)呈负相关。结论高血乳酸可能为糖尿病脂代谢紊乱及糖尿病肾脏病的潜在危险因素,对于2型糖尿病患者而言,早期监测血乳酸水平及积极防治高乳酸血症对于纠正脂代谢紊乱、延缓肾功能恶化具有重要意义。Objective To explore the variation of human-associated metabolic indicators among type 2 diabetes patients accompanied with hyperlactic acidemia. Methods One hundred cases of type 2 diabetes patients were divided into hyperlactic acidemia group（ n =50） and control group（ n = 50）,and the height,weight,BMI,WC,HC,WSR,WHR,FPG,Hb A1 c,TC,TG,LDL,HDL,CR,BUN,24 h urine microalbumin,GFR and Ccr were measured and calculated between the two groups. Results 1The CR,TG,WSR,24 h urine microalbumin levels in hyperlactic acidemia group were significantly higher than those in the control group（ P〈0. 05）,and the GFR,Ccr levels were less than those of the control group（ P〈0. 05）. while the BMI,WC,HC,WHR,FPG,Hb A1 c,TC,LDL,BUN levels were not significantly different between the two groups（ P〉0. 05）. 2The Pearson correlation analysis showed： lactic acid was positively correlated with CR（ r = 0. 354,P〈0. 001）. It was negatively correlated with HDL（ r =- 0. 260,P〈0. 05）,GFR（ r =- 0. 287,P〈0. 05） and Ccr（ r =- 0. 205,P〈0. 05）.Conclusion High-level lactic acid may be a potential risk factor of dyslipidemia and diabetic nephropathy. Preventing and treating hyperlactic academia effectively to correct dyslipidemia and delay the deterioration of renal function could be more meaningful for type 2 diabetes patients.

关 键 词：糖尿病 高乳酸血症 代谢指标 糖尿病肾病 

分 类 号：R587.1[医药卫生—内分泌]