摘要
目的探讨老年2型糖尿病(T2DM)患者尿微量清蛋白/尿肌酐(UACR)与脂蛋白(a)〔Lp(a)〕的相关性。方法选取2011年1月—2012年10月本院收治T2DM患者106例和非糖尿病的其他疾病患者30例(非糖尿病对照组)。根据UACR将T2DM患者分为糖尿病肾病组(UACR≥30 mg/g,50例)和糖尿病非肾病组(UACR<30mg/g,56例)。检测各组患者的生化指标及尿微量清蛋白,采用Pearson相关分析各指标与UACR的相关性,然后采用Logistic回归分析T2DM患者UACR的危险因素。结果 (1)3组患者低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、Lp(a)、尿素、肌酐、空腹血糖(FBG)、糖化血红蛋白(HbA1c)水平及UACR比较,差异均有统计学意义(P<0.05)。(2)非糖尿病对照组和糖尿病非肾病组Lp(a)水平与UACR无相关性(r=-0.290,P=0.120;r=0.163,P=0.230);糖尿病肾病组Lp(a)水平与UACR呈正相关(r=0.363,P<0.01)。(3)单因素Logistic回归分析显示,糖尿病病程、舒张压、LDL-C、ApoB、Lp(a)、HbA1c、空腹C肽(FCP)为UACR可能的危险因素(P<0.2);而多因素Logistic回归分析显示,FCP、糖尿病病程、Lp(a)为UACR的独立危险因素(P<0.05)。结论糖尿病肾病患者Lp(a)水平与UACR呈正相关,且Lp(a)水平为影响UACR的独立危险因素,提示Lp(a)可间接反映T2DM患者的肾脏损害程度。
Objective To analyze the relationship between the urinary mieroalbumin/creatinine ratio （UACR） and lipoprotein （a） [ Lp （a）]in elderly type 2 diabetic （T2DM） patients. Methods A total of 106 elderly patients with T2DM and 30 patients with other diseases who were treated in our hospital form January 2011 to October 2012, were selected as study participants. T2DM patients were divided into diabetic nephropathy group （UACR≥30 my/g, 50 cases） and non- diabetic ne- phropathy group （UACR 〈 30 my/g, 56 cases）, while cases with other diseases were selected as the non -diabetic control group. The biochemical indexes and urinary mieroalbumin were detected among all cases, the correlation between indexes and UACR was analyzed by Pearson correlation analysis, risk factors for UACR among T2DM patients were analyzed by Logistic re- gression analysis. Results There were significant differences in levels of low density lipoprotein cholesterol （ LDL - C）, apoli- poprotein B （ApoB）, Lp （a）, urea, ereatinine, fasting blood glucose （FBG）, glycosylated hemoglobin （HbA1c） and UACR among three groups （ P 〈 0. 05 ） . In non - diabetic control group and non - diabetic nephropathy group, there was no cor- relation between Lp （a） level and UACR （r = -0. 290, P =0. 120; r =0. 163, P =0. 230） . In diabetic nephropathy group, Lp （a） level was positively correlated with UACR （ r =0. 363, P 〈0. 01 ） . Single factor Logistic regression analysis showed that the diabetes duration, diastolic blood pressure, levels of LDL- C, ApoB, Lp （a） , HbA1c and fasting C peptide （FCP） were possible risk factors for UACR （ P 〈 0. 2） . The multivariate Logistic regression analysis showed that FCP level, diabetes duration and Lp （a） level were independent risk factors for UACR （ P 〈 0. 05 ） . Conclusion In patients with diabetic nephropathy, Lp （a） level are positively correlated with UACR, and Lp （a） level is one of the independent risk factors for UACR, so Lp （a） level can indirectly reveal the kidney damage in T2DM patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第6期619-622,共4页
Chinese General Practice
关键词
糖尿病
2型
糖尿病肾病
白蛋白尿
脂蛋白(A)
尿微量清蛋白
尿肌酐
Diabetes mellitus, type 2
Diabetic nephropathies
Albuminuria
Lipoprotein （ a ）
Urinary mi- croalbumin/creatinine ratio
