老年2型糖尿病肾病患者血清胱抑素C、脂蛋白(α)与尿微量清蛋白/肌酐的相关性研究  

Association between the serum CysC,lipoprotein(a)and urinary microalbumin/creatinine ratio among elderly type 2 dibetic patients

作　　者：张翠平[1] 陈璟[1] 

机构地区：[1]江苏省淮安市中医院检验科,223001

出　　处：《国际检验医学杂志》2017年第8期1029-1031,共3页International Journal of Laboratory Medicine

基　　金：淮安市科技局科研基金资助项目(HAS2014016-2)

摘　　要：目的探讨老年2型糖尿病(T2DM)肾病患者血清胱抑素C(CysC)、脂蛋白(α)[Lp(a)]与尿微量清蛋白/肌酐(UACR)的相关性。方法选取2014年12月至2015年12月该院内分泌科收治的老年T2DM患者102例,根据尿微量清蛋白(mALB)将T2DM患者分为糖尿病肾病组(DN,mALB≥20μg/min)48例和糖尿病非肾病组(NDN,mALB<20μg/min)54例;另从体检中心选择同期健康体检者30例作为对照(NC)组。检测各组患者的生化指标、CysC及尿mALB,采用Pearson线性相关分析各指标与UACR的相关性,然后采用Logistic回归分析T2DM肾病患者UACR的危险因素。结果 3组患者低密度脂蛋白胆固醇(LDL-C)、Lp(a)、尿素、肌酐、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、CysC水平及UACR比较,差异均有统计学意义(P<0.05);NC和NDN组CysC、Lp(a)水平与UACR均无相关性;DN组CysC、Lp(a)水平与UACR呈正相关(r=0.658,P<0.01;r=0.525,P<0.05);Logistic回归分析显示,糖尿病病程、CysC、Lp(a)为UACR的独立危险因素(P<0.05)。结论 DN患者CysC和Lp(a)水平与UACR呈正相关,且CysC是反映T2DM患者早期肾损害程度的敏感指标;Lp(a)水平为影响UACR的独立危险因素,可反映DN患者的肾脏损害程度。Objective To analyze the relationship between the serum CysC,lipoprotein（a）[Lp（a）]and the urinary microalbumin/creatinine ratio in elderly type 2dibetic（T2CM）patients.Methods A total of 102 elderly patients with T2 CM who were treated in our hospital from December 2014 to December 2015 were selected.The patients were divided into diabetic nephropathy（DN）group（mALB≥20μg/min,48cases）and non-diabetic nephropathy（NDN）group（mALB〈20μg/min,54cases）according the levels of urinary mALB,while 30 cases of healthy controls were selected from physical examination center.The biochemical indexes,CysC,Lp（a）and UACR were detected among all cases.The correlation between indexes and UACR was analyzed by Pearson correlation analysis,risk factors for UACR among DN patients were analyzed by Logistic regression analysis.Results There were significant differences in levels of low density lipoprotein cholesterol（LDL-C）,Lp（a）,urea,creatinine,fasting blood glucose（FBG）,glycosylated hemoglobin（HbA1c）,Cysc,and UACR among these groups（P〈0.05）.No correlation between CysC、Lp（a）and UACR was found in normal-control group and non-diabetic nephropathy group.In diabetic nephropathy group,there was a positive correlation between CysC,Lp（a）and UACR（r=0.658,P〈0.01;r=0.525,P〈0.05）.The Logistic regression analysis showed that diabetes duration,CysC,Lp（a）were independent risk factors for UACR（P〈0.05）.Conclusion In patients with diabetic nephropathy,CysC,Lp（a）are positively correlated with UACR,and CysC is a sensitive index that reflect early renal damage in T2 DM patients.Lp（a）level is one of the independent risk factors for UACR,which can reveal the kidney damage in DN patients.

关 键 词：2型糖尿病 糖尿病肾病 胱抑素C 脂蛋白Α 尿微量清蛋白/肌酐 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]