糖化血红蛋白与2型糖尿病肾病的相关性分析  

Correlation analysis of glycated hemoglobin and type 2 diabetic nephropathy

作　　者：王芳芳[1] 刘玉梅[1] 尤崇革[1] 党颖强 马月 赵美玲 WANG Fang-fang;LIU Yu-mei;YOU Chong-ge(Laboratory medicine center,Second Hospital of Lanzhou University,Gansu Lanzhou 730030)

机构地区：[1]兰州大学第二医院检验医学中心,甘肃兰州730030 [2]兰州大学第二临床医学院,甘肃兰州730030

出　　处：《医学检验与临床》2024年第8期5-9,共5页Medical Laboratory Science and Clinics

基　　金：甘肃省高等学校创新基金项目,项目编号:2021B-062;兰州大学第二临床医学院“萃英学子科研培育计划”项目,项目编号:CYXZ2021-64;兰州大学第二临床医学院“萃英学子科研培育计划”项目,项目编号:CYXZ2022-34。

摘　　要：目的:本文主要针对糖化血红蛋白,(glycated hemoglobin,HbA1c)水平与2型糖尿病患者肾脏疾病事件发生的关系进行探讨。方法:选取兰州大学第二医院2021年1月-2023年1月间住院的2型糖尿病(Type2 diabetes,T2DM)患者372例作为研究对象,根据是否并发肾脏疾病将其分为糖尿病肾病组169例,糖尿病非肾病组203例,另取我院健康体检人群200例作为对照组。三组间分别空腹抽取静脉血,分析比较糖尿病肾病组、糖尿病非肾病组及对照组患者的空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及HbA1c指标水平,研究各指标水平与糖尿病肾病的相关性。结果:糖尿病患者(非肾病组及肾病组)TC、LDL-C、FPG、HbA1c值均显著高于正常对照组(P<0.05),而HDL-C值显著低于正常对照组(P<0.05)。糖尿病肾病组年龄、FPG和HbA1c与糖尿病非肾病组显著差异(P<0.05),且按性别分层结果显示,在男性中,与糖尿病非肾病组比较,糖尿病肾病组HbA1c具有显著差异(P=0.003);而在女性中,糖尿病肾病组的年龄和HbA1c显著高于糖尿病非肾病组(P<0.05)。Pearson相关性分析显示HbA1c水平与年龄、FPG、TC、LDL-C均成正相关,(r=0.094、0.536、0.495、0.540,P<0.05),与HDL-C成负相关(r=-0.574,P<0.05)。多元线性回归分析显示,年龄、TC、HDL-C、LDL-C是HbA1c水平升高的独立影响因素。结论:2型糖尿病肾病患者HbA1c水平与糖尿病肾病的发生相关,对糖尿病肾病有重要的诊断和预测价值。Objective:To study the relationships between the levels of glycated hemoglobin(HbA1c)and renal disease events in patients with type 2 diabetes.Methods:A total of 372 patients with Type 2 diabetes(T2DM)who were hospitalized in the Second Hospital of Lanzhou University from January 2021 to January 2023 were selected as the study objects,and were divided into diabetic nephropathy group(169 cases)and diabetic non-nephropathy group(203 cases)according to whether they had kidney disease.Another 200 patients with apparent normal physical examination were selected as healthy control group.Fasting venous blood was drawn between the three groups.Glycated hemoglobinserum lipid index and fasting plasma glucose in diabetic nephropathy group,diabetic non-nephropathy group and control group were analyzed and compared.To study the correlation between each index level and diabetic nephropathy.Results:The values of TC,LDL-C,FPG and HbA1c had a significant difference between three groups,while the values of HDL-C were significantly lower than those of the normal control group.The age,FPG and HbA1c had a significant difference in the diabetic nephropathy group compared with the diabetic non-nephropathy group(P<0.05),and the results stratified by sex showed that there was a significant difference in HbAlc in the diabetic nephropathy group compared with the diabetic non-nephropathy group in men(P-0.003).In women,the age and HbA1c in diabetic nephropathy group were significantly higher than those in diabetic non-nephropathy group(P<0.05).Pearson correlation analysis showed that HbA1c level was positively correlated with age,FPG,TC and LDL-C(r=0.094,0.536,0.495,0.540,P<0.05),and negatively correlated with HDL-C(r=-0.574,P<0.05)Age,TC,HDL-C and LDL-C were independent influencing factors for the increase of HbA1c level.Conclusion:The level of HbAlc in patients with type 2 diabetic nephropathy is associated with the occurrence of diabetic nephropathy,and has important diagnostic and predictive value for diabetic nephropathy.

关 键 词：2型糖尿病 糖尿病肾病 糖化血红蛋白 血脂 空腹血糖 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]