男性2型糖尿病患者肾小管损伤及肾功能下降的影响因素  

Influencing factors of renal tubular injury and renal function decline in male patients with type 2 diabetes mellitus

作　　者：姜莹莹 闫慧 单春艳[1] JIANG Yingying;YAN Hui;SHAN Chunyan(Department of Nephrology,Chu Hsien-I Memorial Hospital of Tianjin Medical University,Tianjin 300134,China)

机构地区：[1]天津医科大学朱宪彝纪念医院肾内科,300134 [2]天津医科大学朱宪彝纪念医院医务科,300134

出　　处：《中国糖尿病杂志》2023年第8期581-585,共5页Chinese Journal of Diabetes

基　　金：天津医科大学朱宪彝纪念医院科研基金(ZXY-YJJ2020-5)。

摘　　要：目的探讨男性T2DM患者肾小管损伤及肾功能下降的影响因素。方法选取2019年1月至2021年7月于天津医科大学朱宪彝纪念医院肾内科住院治疗的男性T2DM患者460例。根据肾小管损伤标志物分为肾小管正常组(RTN,n=166)及肾小管损伤组(RTI,n=294)。再根据eGFR水平分为肾功能正常组(RFN,n=396)及肾功能下降组(RFD,n=64)。比较各组一般资料及生化指标,Logistic回归分析男性T2DM患者肾小管损伤及肾功能下降的影响因素。结果与RTN组比较,RTI组FPG、HbA1c、中性粒细胞与淋巴细胞比值(NLR)、TG、血尿酸(SUA)、BUN、血肌酐(Scr)、UACR、β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、N-乙酰-β-D-葡萄糖苷酶(NAG)升高(P<0.05),eGFR降低(P<0.05)。与RFN组比较,RFD组DM病程、NLR、BUN、Scr、UACR、β2-MG、RBP、NAG升高(P<0.05),FPG、HbA1c、eGFR降低(P<0.05)。Spearman相关分析显示,eGFR与DM病程、NLR、UACR、β2-MG、RBP呈负相关(P<0.05)。Logistic回归分析显示,FPG、NLR、SUA、UACR是男性T2DM患者肾小管损伤的危险因素,NLR、UACR、β2-MG、RBP是肾功能下降的危险因素。结论NLR、UACR是男性T2DM患者肾小管损伤、肾功能下降的危险因素,FPG、SUA是肾小管损伤的危险因素,β2-MG、RBP是肾功能下降的危险因素。合并肾小管损伤的男性T2DM患者更易发生肾功能下降。Objective To investigate the influencing factors of renal tubular injury and renal function decline in male patients with type 2 diabetes mellitus(T2DM).Methods A total of 460 male patients with T2DM hospitalized in the Department of Nephrology in Chu Hsien-I Memorial Hospital of Tianjin Medical University from January 2019 to July 2021 were selected and divided into the renal tubular normal group(RTN,n=166)and the renal tubular injury group(RTI,n=294)according to whether there were abnormal markers of renal tubular injury.The patients were divided into renal function normal group(RFN,n=396)and renal function decline group(RFD,n=64)according to the level of estimated glomerular filtration rate(eGFR).General data and laboratory parameters were compared between groups.Binary Logistic regression was used to analyze the influencing factors of renal tubular injury and renal function decline in male T2DM patients.Results Compared with RTN group,the levels of FPG,HbAic,NLR,TG,SUA,BUN,Scr,UACR,β2-MG,RBP and NAG were higher while eGFR was lower in RTI group.Compared with RFN group,DM duration,NLR,BUN,Scr,UACR,p2-MG,RBP and NAG were higher while FPG,HbAic and eGFR were lower in RFD group.eGFR was negatively correlated with DM duration,NLR,UACR.β2-MG and RBP.Logistic regression analysis showed that FPG,NLR,SUA and UACR were risk factors for renal tubular injury in male T2DM patients.NLR,UACR,β2-MG and RBP were risk factors for renal function decline.Conclusion NLR and UACR were the common risk factors for tubular injury and renal function decline in male patients with T2DM.FPG,SUA were risk factors for renal tubular injury,β2-MG and RBP were risk factors for renal function decline.Male T2DM patients combined with tubule injury were more likely to have renal function decline.

关 键 词：男性 糖尿病 2型 肾小管损伤 肾小球滤过率 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]