摘要
目的 探讨DKD与脑小血管病(CSVD)及其影像学特征的相关性。方法 选取2022年1~8月于成都中医药大学附属医院内分泌科住院治疗的T2DM患者476例,根据UACR分为单纯T2DM组(T2DM,UACR<30mg/g,n=330)及DKD组(UACR≥30mg/g,n=146)。比较两组一般资料、生化指标及头颅磁共振成像,分析DKD与CSVD的相关性及白质高信号(WMHs)严重程度的影响因素。结果 DKD组年龄、DM病程、TG、血肌酐、HbA1c、血尿酸、胱抑素C、纤维蛋白原及高血压发生率高于T2DM组(P<0.05),谷丙转氨酶低于T2DM组(P<0.05)。Spearman相关分析显示,DKD与WMHs、腔隙性梗死(LI)、脑萎缩呈正相关(P<0.05),eGFR与WMHs、LI、脑萎缩呈负相关(P<0.05)。Logistic回归分析显示,年龄和HbA1c是WMHs严重程度的影响因素。结论 DKD患者CSVD发生率更高,可能与eGFR评估的肾功能恶化相关。HbA1_(c)可能对WMHs严重程度有预测价值。
Objective To explored the correlation between diabetic kidney disease (DKD) and MRI of cerebral small vessel disease(CSVD).Methods 476 type 2 diabetes mellitus(T2DM) patients who were hospitalized in Chengdu University of Traditional Chinese Medicine Affiliated Hospital from January to August 2022 were selected and divided into simple T2DM group (UACR<30 mg/g,n=330)and DKD group(UACR≥30 mg/g,n=146).General data,biochemical indicators and head MRI images of the two groups were compared.The correlation between DKD and CSVD and the influencing factors of white matter hyperintensities(WMHs) severity were analyzed.Results Age,DM duration,TG,Scr,HbA_1c,SUA,cystatin C (Cys C),fibrinogen (Fib) and the incidence of hypertension were higher(P<0.05),while the ALT was lower in DKD group than in T2DM group(P<0.05).Spearman correlation analysis showed tha the presence of DKD was positively correlated with WMHs,lacunar infarction (LI) and brain atrophy (P<0.05).eGFR was negatively correlated with WMHs,LI and brain atrophy(P<0.05).Logistic regression analysis showed that age and HbA_(1c) were the influencing factors for the severity of WMHs.Conclusion Patients with DKD have a higher incidence of CSVD,which may be related to worsening renal function.HbA_(1c) may have predictive value for the severity of WMHs.
作者
唐铭悦
邬颖华
TANG Mingyue;WU Yinghua(School of Medicine and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2024年第5期357-360,共4页
Chinese Journal of Diabetes
基金
成都中医药大学“杏林学者”学术骨干人才项目(XSGG2018017)。
关键词
糖尿病肾脏疾病
脑小血管病
糖尿病
2型
白质高信号
Diabetic kidney disease:Cerebral small vessel disease
Diabetes mellitus,type 2
White matterhyperintensities
