血清总胆红素和γ-谷氨酰转肽酶与2型糖尿病患者低度白蛋白尿的相关性研究  

Study on the correlation between serum total bilirubin and γ-glutamyltranspeptidase and low albuminuria in type 2 diabetic patients

作　　者：商书霞[1] 赵军魁[1] 孙秋杰 丁增学 贾红丽 宋光耀[3] 郭洪涛[1] SHANG Shuxia;ZHAO Junkui;SUN Qiujie;DING Zengxue;JIA Hongli;SONG Guangyao;GUO Hongtao(The General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.,Handan 056200,Hebei,China;North China Medical Health Industry Group Co.,Ltd.Shijiazhuang 050066,Hebei,China;The General Hospital of Hebei Prov-ince,Shijiazhuang 050051,Hebei,China)

机构地区：[1]冀中能源峰峰集团有限公司总医院,河北邯郸056200 [2]华北医疗健康产业集团有限公司,河北石家庄050066 [3]河北省人民医院,河北石家庄050051

出　　处：《现代中西医结合杂志》2018年第23期2521-2524,2528,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨血清总胆红素(TBil)和γ-谷氨酰转肽酶(GGT)与2型糖尿病(T2DM)患者低度白蛋白尿的相关性。方法选取T2DM患者462例,分别根据血清TBil中位数16.8μmol/L分为低TBil组(221例)和高TBil组(241例),根据血清GGT中位数23.0 IU/L分为低GGT组(226例)和高GGT组(236例),比较各组患者的临床及实验室指标。根据尿白蛋白/肌酐比值(UACR)的四分位切点分为Q1组(UACR 0~2.28 mg/g)、Q2组(UACR>2.28~3.63 mg/g)、Q3组(UACR>3.63~6.19 mg/g)、Q4组(UACR>6.19~30.0 mg/g),统计各组血清TBil、GGT水平,采用Logistic回归分析法分析血清TBil、GGT水平与UACR的关系。结果低TBil组体质量指数(BMI)、收缩压(SBP)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、GGT、UACR均明显高于高TBil组(P均<0.05),高密度脂蛋白胆固醇(HDL-C)明显低于高TBil组(P<0.05)。高GGT组BMI、SBP、FPG、HbA1c、TG、ALT、UACR均明显高于低GGT组(P均<0.05),TBil明显低于低GGT组(P<0.05)。与Q1组相比,Q3、Q4组GGT水平明显升高,Q2、Q3、Q4组TBil水平逐渐降低;Logistic回归分析结果显示,在校正性别、年龄、病程、BMI、SBP、舒张压(DBP)、FPG、HbA1c、TC、TG、LDL-C、HDL-C、ALT、谷草转氨酶(AST)后,UACR与TBil、GGT仍具有明显相关性。结论随着UACR水平升高,TBil水平降低,GGT水平升高,血清TBil及GGT可能成为早期T2DM肾病发生风险的预测因素。Objective It is to investigate the relationship between serum total bilirubin（ TBil） and γ-glutamyltranspeptidase（ GGT） and low albuminuria in patients with type 2 diabetes mellitus（ T2DM）. Methods A total of 462 patients with T2DM were enrolled. The patients were divided into low TBil group（ 221 cases） and high TBil group（ 241 cases） according to the median serum TBil of 16. 8 μmol/L. They were divided into low GGT group（ 226 cases） and high GGT group（ 236 cases） according to the median serum GGT of 23. 0 IU/L. The clinical and laboratory indicators of each group were compared. According to the quartile cut point of urinary albumin/creatinine ratio（ UACR）,they were divided into Q1 group（ UACR 0-2. 28 mg/g）,Q2 group（ UACR 2. 28-3. 63 mg/g）,Q3 group（ UACR 3. 63-6. 19 mg/g）,Q4 group（ UACR 6. 19-30. 0 mg/g）,the serum TBil and GGT levels were statistically analyzed. The relationship between serum TBil and GGT levels and UACR was analyzed by logistic regression analysis. Results The body mass index（ BMI）,systolic blood pressure（ SBP）,fasting blood glucose（ FPG）,glycosylated hemoglobin（ Hb A1 c）,total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterol（ LDL-C）,alanine aminotransferase（ ALT）,GGT,UACR in low TBil group were significantly higher and high-density lipoprotein cholesterol（ HDL-C） was significantly lower than those in the high TBil group（ P〈0. 05）. BMI,SBP,FPG,Hb A1 c,TG,ALT and UACR in the high GGT group were significantly higher than those in the low GGT group（ P〈0. 05）,and TBil was significantly lower than the low GGT group（ P〈0. 05）.Compared with Q1 group,GGT levels in Q3 and Q4 groups were significantly increased,and TBil level was gradually decreased in Q2,Q3,and Q4 groups. Logistic regression analysis showed that after gender,age,disease duration,BMI,SBP,and diastolic blood pressure（ DBP）,FPG,Hb A1 c,TC,TG,LDL-C,HDL-C,ALT,and aspartate aminotransferase（ AST） adjusted,UACR s

关 键 词：总胆红素 Γ-谷氨酰转肽酶 2型糖尿病 低度白蛋白尿 尿白蛋白/肌酐比值 

分 类 号：R587.1[医药卫生—内分泌]