2型糖尿病患者肾小球滤过率与胰岛功能及代谢指标的相关性研究  

Correlation between Glomerular Filtration Rate and Islet Function and Metabolic Index in Type 2 Diabetic Patients

作　　者：李会芳 刘玉金[1] 苗霞 朱昭明[1] LI Hui-fang;LIU Yu-jin;MIAO Xia;ZHU Zhao-rning(Nephrology Department,Hebei Yiling Hospital,Shijiazhuang,Hebei Province,050091 China)

机构地区：[1]河北以岭医院肾病科,河北石家庄050091

出　　处：《糖尿病新世界》2018年第18期3-6,共4页Diabetes New World Magazine

摘　　要：目的探讨2型糖尿病(T2DM)患者肾小球滤过率(GFR)与口服葡萄糖耐量试验(OTCG)后总C肽(T-CF)、总胰岛素(T-RI)、总血糖(T-GLU)及血β-微球蛋白(β2-GM)、血糖化血红蛋白(HbA1c)、血脂、血尿酸(UA)水平之间的关系。方法选取2017年1—7月门诊就诊新发T2DM患者85例,行口服葡萄糖耐量试验。同时,根据年龄、性别、肝肾功能相关指标,计算肾小球滤过率。根据糖尿病肾病(DN)病理损伤高血流动力学特点分为3个组,依GFR-降低组;GFR正常组;GFR-高滤过组。肾脏损伤程度:GFR-降低组>GFR正常组>GFR高滤过组。比较各组胰岛功能及临床指标的差异,分析GFR水平与胰岛功能及代谢指标的相关性;不同指标对GFR的相关性及不同组间各指标的差异性。结果血总胰岛素水平、血β-GM与GFR明显相关(P<0.000 1);血HbA1c、血T-CF、血TG、血UA与GFR明显相关(P<0.000 1);血糖(GLU)、血胆固醇(CHO)与GFR无相关性(P>0.05)。结论 T2DM患者血T-RI、血β2-GM、血T-CF、血UA、血TG、HbA1c与糖尿病肾病GFR密切相关,临床应积极干预。单纯高血糖、血CHO水平与糖尿病肾病GFR无明显相关性。Objective To investigate total glomerular filtration rate （GFR） and oral glucose tolerance test （OTCG） in patients with type 2 diabetes mellitus （T2DM） after total C-peptide （T-CF）, total insulin （T-RI）, and total blood glucose （T-GLU） and the relationship between blood β-mieroglobulin （β2-GM）, glyeated hemoglobin （HbA1c）, blood lipids, and blood uric acid （UA） levels. Methods 85 patients with newly diagnosed T2DM from January to July 2017 were enrolled in the outpatient department and the oral glucose tolerance test was performed. At the same time, glomerular filtration rate was calculated according to age, gender, and liver and kidney function related indicators. The diabetic nephropathy （DN） high hemodynamie characteristics of pathological lesions divided into three groups, GFR-redueing group; GFR normal group; GFR - hyperfihration group. The degree of kidney damage： GFR-reduee the grou P〉GFR normal grou P〉GFR high filtration group. The differences of islet function and clinical indexes were compared, and the correlation between GFR level and islet function and metabolic index was analyzed. The correlation of different indexes on GFR and the differences among different groups were compared. Results Total blood insulin levels, blood β-GM and GFR were significantly correlated （P〈0.000 1）; blood HbA1c, blood T-CF, blood TG, blood UA and GFR were significantly correlated （P〈0.000 1）; blood glucose （GLU）, blood cholesterol （CHO） had no correlation with GFR （P〉0.05）. Conclusion Blood T-RI, blood β2-GM, blood T-CF, blood UA, blood TG, HbAlc are closely related to diabetic nephropathy GFR in T2DM patients, and clinical intervention should be actively carried out. There was no significant correlation between simple hyperglycemia and blood CHO levels and diabetic nephropathy GFR.

关 键 词：肾小球滤过率 口服葡萄糖耐量试验 胰岛功能 肾功能 血脂 

分 类 号：R59[医药卫生—内科学]