2型糖尿病肾病患者血清UA、25(OH)D3、baPWV水平变化的相关性分析  

Correlation Analysis of Serum UA,25(OH)D3 and baPWV Levels in Patients with Type 2 Diabetic Nephropathy

作　　者：雒杲 贺枫 牛璐 李凡凡 李京娟 安斌斌 成晓琼 王金羊[2] LUO Gao;HE Feng;NIU Lu;LI Fan-fan;LI Jing-juan;AN Bin-bin;CHENG Xiao-qiong;WANG Jin-yang(The First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730030,Gansu,China;Department of Endocrinology,Gansu Provincial People's Hospital,Lanzhou 730030,Gansu,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730030 [2]甘肃省人民医院内分泌科,甘肃兰州730030

出　　处：《医学信息》2022年第24期46-49,共4页Journal of Medical Information

基　　金：国家自然科学基金资助项目(编号:81760147);甘肃省自然基金项目(编号:21JR1RA013)。

摘　　要：目的对2型糖尿病肾病患者的血清UA、25(OH)D_(3)、baPWV水平变化进行相关性分析,为糖尿病肾病的早期预防和诊治提供新的解决思路。方法选取于2021年1月-2022年2月甘肃省人民院内分泌科住院治疗的2型糖尿病(T2DM)患者299例,根据尿蛋白排泄率(UAER)分为非DN组(UAER<20μg/min,100例)、早期DN组(20μg/min≤UAER≤200μg/min,108例)、临床DN组(UAER>200μg/min,91例),比较三组血清UA、25(OH)D_(3)、baPWV水平,分析UA、25(OH)D_(3)、baPWV与肾功能指标的相关性;Logistic回归分析法筛选影响糖尿病肾病的因素。ROC曲线评价UA、baPWV对DN的预测价值。结果三组UA、25(OH)D_(3)、baPWV水平比较,差异有统计学意义(P<0.05),且UA、baPWV水平呈现均逐渐升高,而25(OH)D_(3)水平呈现逐渐降低;Spearman相关分析显示,2型糖尿病肾病患者25(OH)D_(3)水平与UA、UACR、UAER、Scr均呈负相关(r=-0.223、-0.324、-0.222、-0.141,P<0.05);baPWV与UA、糖尿病病程、UACR、UAER均呈正相关(r=0.185、0.201、0.293、0.307,P<0.05);UA与UACR、UAER、Scr均呈正相关(r=0.223、0.407、0.339,P<0.05);多因素Logistic回归分析显示:UA、baPWV、25(OH)D_(3)为糖尿病肾病的独立影响因素;ROC曲线分析显示:UA的曲线下面积(AUC)为0.774,高于baPWV的曲线下面积(AUC)0.655,血清UA比baPWV的评估价值较好。结论2型糖尿病肾病患者中UA、baPWV水平普遍升高,而血清25(OH)D_(3)水平相对较低。2型糖尿病肾病患者的血清UA、baPWV、25(OH)D_(3)水平对肾脏功能检测及评估具有重要的临床价值。Objective To analyze the correlation between serum UA,25(OH)D_(3)and baPWV levels in patients with type 2 diabetic nephropathy,and to provide new solutions for the early prevention,diagnosis and treatment of diabetic nephropathy.Methods A total of 299 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the Department of Endocrinology,Gansu Provincial People’s Hospital from January 2021 to February 2022were selected.According to urinary albumin excretion rate(UAER),they were divided into non-DN group(UAER<20μg/min,100 cases),early DN group(20μg/min≤UAER≤200μg/min,108 cases)and clinical DN group(UAER>200μg/min,91 cases).The levels of serum UA,25(OH)D_(3)and baPWV were compared among the three groups.The correlation between UA,25(OH)D_(3),baPWV and renal function indexes were analyzed.Logistic regression analysis was used to screen the factors affecting diabetic nephropathy.ROC curve was used to evaluate the predictive value of UA and baPWV for DN.Results There were significant differences in the levels of UA,25(OH)D_(3)and baPWV among the three groups(P<0.05),and the levels of UA and baPWV increased gradually,while the level of 25(OH)D_(3)decreased gradually.Spearman correlation analysis showed that 25(OH)D_(3)level was negatively correlated with UA,UACR,UAER and Scr in patients with type 2 diabetic nephropathy(r=-0.223,-0.324,-0.222,-0.141,P<0.05);baPWV was positively correlated with UA,duration of diabetes,UACR and UAER(r=0.185,0.201,0.293,0.307,P<0.05);UA was positively correlated with UACR,UAER and Scr(r=0.223,0.407,0.339,P<0.05).Multivariate Logistic regression analysis showed that UA,baPWV and 25(OH)D_(3)were independent influencing factors of diabetic nephropathy.ROC curve analysis showed that the area under the curve(AUC)of UA was 0.774,which was higher than that of ba PWV(AUC=0.655).Conclusion UA and baPWV levels are generally elevated in patients with type 2 diabetic nephropathy,while serum 25(OH)D_(3)levels are relatively low.The levels of serum UA,baPWV and 25(OH)D_(3)in patie

关 键 词：25羟维生素D3 尿酸 糖尿病肾病 臂踝脉搏波传导速度 

分 类 号：R587.1[医药卫生—内分泌]