2型糖尿病患者不同脂质参数与糖尿病肾病的关系  

Relationships between different lipid parameters and diabetic kidney disease in T2DM patients

作　　者：李勇飞 汪洋畅 罗彩霞 王沛坚[3,4] Li Yongfei;Wang Yangchang;Luo Caixia;Wang Peijian(Department of Nephrology,Qingxin District People's Hospital,Qingyuan,Guangdong 511800,China;Department of Women's and Children's Health,Qingxin District People's Hospital,Qingyuan,Guangdong 511800,China;Department of Cardiology,First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,China;Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes,Chengdu,Sichuan 610500,China)

机构地区：[1]清远市清新区人民医院肾内科,广东清远511800 [2]清远市清新区人民医院妇女儿童保健科,广东清远511800 [3]成都医学院第一附属医院心血管内科,四川成都610500 [4]衰老与血管稳态四川省高校重点实验室,四川成都610500

出　　处：《现代临床医学》2020年第3期161-163,169,共4页Journal of Modern Clinical Medicine

基　　金：国家自然科学基金项目(81400289);四川省杰出青年学术技术带头人资助计划(2016JQ0032)。

摘　　要：目的:探讨2型糖尿病(T2DM)患者不同脂质参数与糖尿病肾病(DKD)发生的相关性。方法:检测226例T2DM患者血清TC、TG、LDL-C、HDL-C水平及相关生化指标,计算血浆致动脉硬化指数(AIP)以及脂质三角相关指标(TC/HDL-C、TG/HDL-C、LDL-C/HDL-C)。根据DKD临床诊断标准和Mogensen分期标准分为:Ⅰ~Ⅱ期组136例,Ⅲ期组55例,Ⅳ~Ⅴ期组35例。应用多因素logistic回归分析不同脂质参数与DKD发生的关系。结果:与Ⅰ~Ⅱ期组相比,随着DKD分期加重,TC、TG、LDL-C、LDL-C/HDL-C、AIP水平明显增高(P<0.01)。LDL-C/HDL-C和AIP与24 h尿蛋白水平呈正相关(r=0.724;r=0.769,均P<0.05)。LDL-C/HDL-C和AIP是T2DM合并DKD患者的独立预测因子(P=0.002;P=0.004)。结论:LDL-C/HDL-C和AIP对T2DM合并DKD病情进展有较高的预测价值,可为临床诊治提供参考。Objective:To explore the relationships between different lipid parameters and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM).Methods:The serum TC,TG,LDL-C,HDL-C levels and related biochemical indexes were measured in 226 T2DM patients.The atherogenic index of plasma(AIP)and lipid trigonometry related index(TC/HDL-C,TG/HDL-C,LDL-C/HDL-C)were calculated.According to the clinical diagnosis standard of DKD and the stage standard of Mogensen,the patients were divided into three groups:136 cases in stageⅠ-Ⅱ,55 cases in stageⅢand 35 cases in stageⅣ-Ⅴ.Multivariate logistic regression was used to analyze the relationships between different lipid parameters and DKD.Results:Compared with the stageⅠ-Ⅱgroup,the levels of TC,TG,LDL-C,LDL-C/HDL-C and AIP increased significantly with the aggravation of DKD stage(P<0.01).LDL-C/HDL-C and AIP were positively correlated with 24-hour urinary protein level(r=0.724;r=0.769,all P<0.05).LDL-C/HDL-C and AIP were independent predictors of T2DM with DKD(P=0.002;P=0.004).Conclusion:LDL-C/HDL-C and AIP have high predictive value for the progression of T2DM with DKD,which can provide a reference for clinical diagnosis and treatment.

关 键 词：糖尿病肾病 脂质参数 2型糖尿病 血浆致动脉硬化指数 

分 类 号：R587[医药卫生—内分泌]