新诊断2型糖尿病并早期肾病相关危险因素分析  

Analysis of Risk Factors of Early Diabetic Nephyopathy in Patients with newly Diagnosed Type-2 Diabetes Mellitus

作　　者：陈卫锋[1] 李平[1] 李旭[1] CHEN Wei-feng;LI Ping;LI Xu(Department of Endocrinology The People’s Hospitul of Shihezi,Xinjiang Shihezi,832000)

机构地区：[1]新疆石河子市人民医院内分泌科,新疆石河子832000

出　　处：《农垦医学》2019年第6期509-512,共4页Journal of Nongken Medicine

摘　　要：目的:分析新诊断2型糖尿病(T2DM)并早期糖尿病肾病(EDN)患者各代谢指标,探讨肾损害发生的危险因素,为糖尿病肾病(DN)的早期防治提供临床依据。方法:选择新诊断2型糖尿病患者164例,按尿微量白蛋白排泄率(UAER)水平将患者分为单纯2型糖尿病组(SDM组,UAER<20μg/min)和早期糖尿病肾病组(EDN组,UAER 20~200μg/min),调查吸烟史,测量身高、体重,计算体重指数(BMI),检测空腹血糖(FBG)、糖化血清白蛋白(GPA)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)、胱抑素C(CysC)、空腹胰岛素(FINS),计算稳态模型胰岛素抵抗指数(HOMA-IR),比较两组间上述指标,应用Spearman相关分析及Logistic回归进行统计学分析。结果:EDN组与SDM组相比,吸烟比例、BMI、FBG、GPA、TC、TG、LDL-C、CysC、HOMA-IR水平较高,HDL-C水平较低,差异具有显著性(P<0.05);两组患者HbA1c、UA水平比较,差异无统计学意义(P>0.05);Logistic回归分析显示,BMI、FBG、TC、TG、胰岛素抵抗指数是影响EDN的独立危险因素。结论:吸烟、肥胖、高血糖、高TG、高TC及胰岛素抵抗是发生EDN的危险因素;初发2型糖尿病患者应尽早戒烟、严格控制血糖、体重,改善胰岛素抵抗,纠正脂代谢紊乱,预防糖尿病肾病的发生和发展。Objective:To analyze the Metabolic indicators in newly diagnosed type-2 diabetes patients,explore incidence and risk factors of microalbuminuria and provide the theoretical basis for therapy of diabetes nephropathy.Method:According to urine albumin excretion rate(UAER),One hundred and sixty-four patients with newly diagnosed type-2 diabetes mellitus were divided into two groups:Simple T2DM group(SDM group,UAER<20ug/min)and early Diabetic Nephyopathy group(EDN group,UAER 20-200ug/min).All subjects were investigated the history of smoking,measured body mass index(BMI),fasting blood glucose(FBG),glycosylated plasmaalbumin(GPA),glucosy-lated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),serum Cystatin C(CysC)and fasting insulin.Homeostasis model assessment insulin resistance(HOMA-IR)was calculated.The differences between two groups were analysed with Spearman correlation analysis and Logistic regression analysis.Results:Compared with SDM group,the percentage 0f smoking,BMI,FBG,GPA,TC,TG,LDL-C levels,CysC and HOMA-IR levels in EDN group were higher,while HDL-C levels were lower(P<0.05).There was no significant difference in,HbA1c,UA between two groups(P>0.05).Logistical regression analysis showed that that BMI,FBG,TC,TG and insulin resistance index were independent risk factors for EDN.Conclusion:Smoking,obesity,hyperglycemia,high TG,high TC and insulin resistance are risk factors for EDN.Patients with newly diagnosed type 2 diabetes should be quit smoking,strictly control blood sugar and weight,improve insulin resistance,correct lipid metabolism disorder in order to prevent EDN from occurring and developing.

关 键 词：2型糖尿病 糖尿病肾病 危险因素 

分 类 号：R587.2[医药卫生—内分泌]