内蒙古部分地区2型糖尿病肾病发病的危险因素探讨  

Discussion on risk factors of type 2 diabetic kidney disease in partial areas of Inner Mongolia

作　　者：祝丽姣 李增艳[1] ZHU Li-jiao;LI Zeng-yan(First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014000,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院肾内科,014000

出　　处：《中国实用医药》2023年第10期36-40,共5页China Practical Medicine

摘　　要：目的 探讨内蒙古部分地区住院患者中2型糖尿病肾病发病的危险因素,为该地区糖尿病肾病的防控提供依据。方法 回顾性分析139例2型糖尿病(T2DM)患者的临床资料,按照有无糖尿病肾病(DKD)分为DKD组(59例)和非DKD组(80例)。比较两组基本资料及实验室生化指标,并采用多因素Logistic回归分析DKD发病的独立影响因素。结果 两组患者性别、居住地、体质量指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、舒张压(DBP)比较,差异无统计学意义(P>0.05);DKD组年龄(62.56±10.98)岁、内脏脂肪面积(VFA)(112.41±23.76)cm^(2)、糖化血红蛋白(HbA1c)(8.74±2.13)%、收缩压(SBP)(150.46±22.81)mm Hg(1 mm Hg=0.133 kPa)均高于非DKD组的(58.54±10.37)岁、(98.76±19.51)cm^(2)、(6.93±2.79)%、(129.33±14.05)mm Hg,糖尿病病程(179.76±70.02)个月长于非DKD组的(96.05±75.96)个月,差异具有统计学意义(P<0.05)。两组甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、促甲状腺激素(TSH)、游离甲状腺素(FT_(4))、尿酸(UA)、尿素氮(BUN)及肌酐(Cre)水平比较,差异无统计学意义(P>0.05);DKD组游离三碘甲状腺原氨酸(FT_(3))(2.88±0.45)pmol/L、血清总胆汁酸(TBA)(2.83±1.45)μmol/L低于非DKD组的(3.33±1.51)pmol/L、(3.61±1.81)μmol/L,胱抑素C(Cys-C)(1.43±0.65)mg/L高于非DKD组的(1.02±0.71)mg/L,差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,糖尿病病程、VFA、SBP、血清Cys-C、HbA1c为DKD发病的独立危险因素(P<0.05),血清TBA、FT_(3)为DKD发病的独立保护因素(P<0.05)。结论 内蒙古该地区住院的T2DM患者糖尿病病程长,Cys-C、HbA1c、VFA、SBP水平升高,TBA及正常范围内FT_(3)水平降低为DKD发病的独立危险因素,重视相关指标的监测,对于延缓当地DKD的发生与进展意义重大。Objective To discuss the risk factors of type 2 diabetic kidney disease in partial areas of Inner Mongolia,so as to provide basis for the prevention and treatment of diabetic kidney disease in the region.Methods The clinical data of 139 patients with type 2 diabetes mellitus(T2DM)were retrospectively analyzed.According to whether they had diabetic kidney disease(DKD)or not,patients were divided into DKD group(59 cases)and non-DKD group(80 cases).The basic data and laboratory biochemical indexes were compared between the two groups.Logistic regression analysis was used to analyze the independent influencing factors of DKD.Results There was no statistically significant difference between the two groups in terms of gender,residence,body mass index(BMI),waist-to-hip ratio(WHR),fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PBG),and diastolic blood pressure(DBP)(P>0.05).The age of(62.56±10.98)years old,visceral fat area(VFA)of(112.41±23.76)cm^(2),glycosylated hemoglobin(HbA1c)of(8.74±2.13)%,and systolic blood pressure(SBP)of(150.46±22.81)mm Hg(1 mm Hg=0.133 kPa)in the DKD group were higher than those of(58.54±10.37)years old,(98.76±19.51)cm^(2),(6.93±2.79)%,and(129.33±14.05)mm in the non-DKD group;the duration of diabetes mellitus of(179.76±70.02)months in the DKD group was longer than that of(96.05±75.96)months in the non-DKD group;the differences were statistically significant(P<0.05).The triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),thyroid stimulating hormone(TSH),free thyroxine(FT_(4)),uric acid(UA),blood urea nitrogen(BUN)and creatinine(Cre)levels were compared between the two groups,and the differences were not statistically significant(P>0.05).The free triiodothyronine(FT_(3))of(2.88±0.45)pmol/L and total bile acid(TBA)of(2.83±1.45)μmol/L in the DKD group were lower than those of(3.33±1.51)pmol/L and(3.61±1.81)μmol/L in the non-DK

关 键 词：2型糖尿病肾病 内脏脂肪面积 胱抑素C 总胆汁酸 游离三碘甲状腺原氨酸 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]