单核细胞/高密度脂蛋白比值、尿白蛋白/肌酐比值与糖尿病肾脏疾病严重程度及预后的相关性  

Correlation of monocyte/high density lipoprotein and urinary albumin/creatinine ratio with the se⁃verity and prognosis of diabetic nephropathy

作　　者：朱晓瑞 陆明[1] 郭劝劝 Zhu Xiao-rui;Lu Ming;Guo Quan-quan(Department of Endocrinology,Bengbu Municipal Second People's Hospital,Bengbu 233000,China)

机构地区：[1]蚌埠市第二人民医院内分泌科,蚌埠233000

出　　处：《临床肾脏病杂志》2025年第3期194-200,共7页Journal Of Clinical Nephrology

摘　　要：目的 探讨单核细胞/高密度脂蛋白比值(monocyte/HDL ratio,MHR)、尿白蛋白/肌酐比值(urinary albumin/creatinine ratio,UACR)与糖尿病肾脏疾病(diabetic kidney disease,DKD)严重程度及预后的相关性。方法 前瞻性选择2021年5月1日至2022年5月1日蚌埠市第二人民医院收治的115例DKD患者,依据肾脏病理损伤程度将入组患者分为1期组、2期组、3期组、4期组,比较各组MHR、UACR,Spearman相关性分析法评估MHR、UACR与DKD严重程度的相关性。出院后通过门诊或电话随访1年,依据是否发展为终末期肾病将患者分为预后良好组、预后不良组,Logistic多因素回归分析法明确影响DKD患者预后的危险因素,受试者工作特征曲线评估MHR、UACR预测DKD患者预后不良的效能。结果 DKD不同分期患者MHR、UACR差异具有统计学意义(P<0.05),其中1期组MHR、UACR最低(P<0.05),分别为(5.35±0.45)、(10.62±2.15),4期组MHR、UACR最高(P<0.05),分别为(9.35±1.02)、(200.50±40.58)。Spearman相关性分析结果显示,MHR、UACR与DKD严重程度均呈正相关(r=0.867、0.905,P<0.05)。预后良好组、预后不良组患者糖化血红蛋白[(9.71±1.08)%比(12.95±1.17)%]、总胆固醇[(4.80±0.85)mmol/L比(8.56±1.75)mmol/L]、三酰甘油[(1.46±0.22) mmol/L比(3.46±0.52)mmol/L]、血肌酐[(89.12±10.30)μmol/L比(170.44±22.85)μmol/L]、血尿酸[(5.18±0.75)μmol/L比(7.96±1.16)μmol/L]、胱抑素C[(0.90±0.15)mg/L比(1.88±0.42)mg/L]、低密度脂蛋白[(1.89±0.46)mmol/L比(3.85±0.69)mmol/L]、MHR[(4.38±0.29)比(11.05±0.85)]、UACR[(21.69±4.10)比(170.16±26.50)],差异具有统计学意义(P<0.05)。Logistic多因素回归分析结果显示:糖化血红蛋白(OR=2.344,95%CI:1.925~2.764)、总胆固醇(OR=2.208,95%CI:1.940~2.476)、三酰甘油(OR=2.234,95%CI:1.986~2.363)、血肌酐(OR=2.328,95%CI:2.025~2.631)、血尿酸(OR=2.351,95%CI:2.082~2.621)、胱抑素C(OR=2.363,95%CI:2.071~2.655)、低密度脂蛋白(OR=2.421,95%CI:2.165~2.676)、MHR(OR=2.489,95%CI:2Objective To investigate the correlation of monocyte/high-density lipoprotein ratio(MHR)and urinary albumin/creatinine ratio(UACR)with the severity and prognosis of diabetic kidney disease(DKD).Methods A total of 115 DKD patients treated in Bengbu Second People's Hospital from May 1,2021 to May 1,2022 were prospectively enrolled.They were divided into stage 1 group,stage 2 group,stage 3 group and stage 4 group according to the degree of renal pathological injury.MHR and UACR of each group were compared,and Spearman correlation analysis was used to evaluate the correlation of MHR and UACR with DKD severity.After discharge,patients were followed up by outpa-tient visit or telephone contact for 1 year.According to whether they developed end-stage renal disease(ESRD),the patients were divided into good prognosis group and poor prognosis group.Logistic multi-variate regression analysis was used to identify the risk factors for the prognosis of DKD patients.The re-ceiver operating characteristic curve(ROC)was plotted to evaluate the efficacy of MHR and UACR in predicting the poor prognosis of DKD.Results There were significant differences in MHR and UACR among DKD patients with different stages(P<0.05).The lowest MHR and UACR were detected in stage 1 group[(5.35±0.45)and(10.62±2.15),respectively],and the highest values were found in stage 4 group[(9.35±1.02)and(200.50±40.58),respectively].Spearman correlation analysis showed that MHR and UACR were positively correlated with the severity of DKD(r=0.867,0.905,P<0.05).There were significant differences in HBA1c[(9.71±1.08)%vs(12.95±1.17)%],total cholesterol[(4.80±0.85)mmol/L vs(8.56±1.75)mmol/L],triglyceride[(1.46±0.22)mmol/L vs(3.46±0.52)mmol/L],serum creatinine[(89.12±10.30)μmol/L vs(170.44±22.85)μmol/L],serum uric acid[(5.18±0.75)μmol/L vs(7.96±1.16)μmol/L],cystatin C[(0.90±0.15)mg/L vs(1.88±0.42)mg/L],low density lipoprotein[(1.89±0.46)mmol/L vs(3.85±0.69)mmol/L],MHR[(4.38±0.29)vs(11.05±0.85)]and UACR[(21.69±4.10)vs(170.16±26.50)]between good

关 键 词：糖尿病肾脏疾病 单核细胞 高密度脂蛋白 尿白蛋白/肌酐比值 预后 

分 类 号：R58[医药卫生—内分泌]