Wolf Gunter, Müller Nicolle, Hunger-Battefeld Wilgard, Kloos Christof, Müller Ulrich A
Klinik für Innere Medizin III, Klinikum der Friedrich-Schiller-Universität, Jena, Germany.
Kidney Blood Press Res. 2008;31(5):313-21. doi: 10.1159/000155230. Epub 2008 Sep 15.
BACKGROUND/AIMS: It has been reported that anemia is more common in patients with diabetes mellitus, and that it occurs early in the disease process.
In this study, we evaluated hemoglobin (Hb) values of patients with diabetes type 1 or 2 from a large collective receiving care from a tertiary center. A total of 751 patients with type 1 diabetes and 3,306 patients with type 2 were studied. Correlations were calculated for Hb with the following parameters: metabolic control (HbA(1c) and blood glucose), renal function [estimated glomerular filtration rate (eGFR), serum creatinine, albuminuria, proteinuria], blood leukocytes, duration of diabetes and use of ACE inhibitors/AT1-receptor antagonists.
17% of patients with type 1 diabetes and 14% of those with type 2 had anemia [defined as an Hb <8.5 mmol/l (<13.68 g/dl) in men and <7.5 mmol/l (<12.07 g/dl) in women). There was a close positive correlation between Hb and eGFR, and a negative correlation with albuminuria and proteinuria. These close associations were also confirmed with linear regression analysis. A significant negative correlation was observed between serum creatinine levels and Hb. There was no negative correlation between actual Hb and mean HbA(1c) in the individual follow-up periods. No correlation was found between blood glucose (morning and postprandial blood glucose) and Hb. Blood leukocyte numbers, as a parameter of systemic inflammation, were not correlated with Hb. The use of ACE inhibitors/AT1-receptor antagonists had no adverse effect on Hb in our study cohort.
No negative effects of metabolic control on Hb could be demonstrated in this study.
背景/目的:据报道,贫血在糖尿病患者中更为常见,且在疾病进程早期就会出现。
在本研究中,我们评估了来自三级中心接受治疗的大型群体中1型或2型糖尿病患者的血红蛋白(Hb)值。共研究了751例1型糖尿病患者和3306例2型糖尿病患者。计算了Hb与以下参数的相关性:代谢控制(糖化血红蛋白A1c和血糖)、肾功能[估计肾小球滤过率(eGFR)、血清肌酐、白蛋白尿、蛋白尿]、血白细胞、糖尿病病程以及血管紧张素转换酶抑制剂/血管紧张素Ⅱ1型受体拮抗剂的使用情况。
17%的1型糖尿病患者和14%的2型糖尿病患者患有贫血[定义为男性Hb<8.5 mmol/l(<13.68 g/dl),女性Hb<7.5 mmol/l(<12.07 g/dl)]。Hb与eGFR之间存在密切正相关,与白蛋白尿和蛋白尿呈负相关。这些密切关联也通过线性回归分析得到证实。血清肌酐水平与Hb之间存在显著负相关。在个体随访期间,实际Hb与平均糖化血红蛋白A1c之间未发现负相关。血糖(空腹血糖和餐后血糖)与Hb之间未发现相关性。作为全身炎症参数的血白细胞数量与Hb无关。在我们的研究队列中,血管紧张素转换酶抑制剂/血管紧张素Ⅱ1型受体拮抗剂的使用对Hb没有不良影响。
本研究未证明代谢控制对Hb有负面影响。