不同肥胖指标对2型糖尿病肾脏疾病的预测及适宜切点值  

Prediction for type 2 diabetic kidney disease by different obesity indexes and the appropriate cut-off point

作　　者：方凤贞 张璟[1] FANG Fengzhen

机构地区：[1]福建卫生职业技术学院,福建福州350101

出　　处：《中医临床研究》2021年第31期37-41,共5页Clinical Journal Of Chinese Medicine

基　　金：2019年省卫生健康青年科研课题资助计划(2019-1-78)。

摘　　要：目的:探讨不同肥胖指标对糖尿病肾脏疾病(Diabetic Kidney Disease,DKD)的预测能力和差异,寻找适宜切点值。方法:收集2019年6月-2020年2月在福建省某三级甲等医院内分泌科就诊的2型糖尿病(Diabetes Mellitus Type 2,T2DM)患者(220例)的基本资料,分为单纯T2DM组和2型DKD组。采用二元Logistic回归分析不同肥胖指标与DKD发病的关联,并进一步使用受试者工作特征(Receiver Operating Characteristic,ROC)曲线下面积(Area Under The Curve,AUC)比较不同肥胖指标对DKD的预测能力及适宜切点值。结果:中心型肥胖指标腰围(Waist Circumference,WC)和腰高比(Waist-to-height Ratio,WHTR)是女性DKD的危险因素,全身性肥胖指标身体质量指数(Body Mass Index,BMI)与DKD发病间比较无统计学意义;肥胖指标联合(BMI+WC+WHTR模型,AUC=0.719)预测女性DKD发病风险的能力较优,与WHTR、BMI+WHTR模型的差异有统计学意义(P<0.05);在单一肥胖指标中,WC可能是预测女性DKD发病风险的良好指标(AUC=0.701),与WHTR的差异有显著性统计学意义(P<0.01),适宜切点值为88 cm;在男性中,WHTR可能是预测其DKD发病风险的指标(AUC=0.571),适宜切点值为0.6。结论:不同肥胖指标对2型DKD具有一定的预测能力,性别不同预测效力和切点值各异;女性患者肥胖指标联合预测的效力最优,中心型肥胖指标WC次之。Objective:To investigate the predictive ability and difference of different obesity indicators for type 2 diabetic kidney disease,and to find appropriate cut-off points.Methods:The basic data of type 2 diabetes patients(220 cases)from June 2019 to February 2020 were collected and were divided into the type 2 diabetes group and the type 2 diabetic kidney disease group.Binary Logistic regression was used to analyze the relationship between different obesity indicators and the incidence of DKD,and AUC was further used to compare the predictive ability and appropriate cut-point value of different obesity indicators for DKD.Results:WC and WHTR indexes of central obesity were risk factors for female DKD.There was no significant correlation between BMI of systemic obesity and the onset of DKD.The combination of obesity indexes has a better ability to predict the risk of DKD in women(AUC=0.719 in the BMI+WC+WHTR model),and the difference was statistically significant compared with the WHTR model and the BMI+WHTR model(P<0.05).Among single obesity indicator,WC may be a good indicator for predicting the risk of female DKD(AUC=0.701),the difference was statistically significant compared with WHTR(P<0.01),and the value of appropriate cut-off point was 88 cm.WHTR may be an indicator for predicting the risk of male DKD(AUC=0.571),and the value of appropriate cut-off point was 0.6.Conclusion:Different obesity indicators have certain predictive power for diabetic kidney disease,and different genders have different predictive powers and cut-off points.The predictive power of combined obesity indicators for female patients is the best,followed by WC index of central obesity.

关 键 词：身体质量指数 腰围 腰高比 2型糖尿病 肾脏疾病 

分 类 号：R587.1[医药卫生—内分泌]