Zhou Yan, Guo Li-xin, Yu Dong-ni, Zhou Lu, Wang Yao, Mou Zhong-qing, Wang Xiao-xia, Zhang Li-na, Li Ming
Department of Endocrinology of Beijing Hospital of the Ministry of Health, Beijing 100730, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2012 Jun;33(6):610-3.
To analyze the prevalence rate of diabetic nephropathy (DN) and the related factors on DN among type 2 diabetic patients.
A total number of 1758 type 2 diabetic patients who were hospitalized in the Beijing Hospital from 2003 to 2010 were analyzed retrospectively. Three groups were divided according to the rate of urinary albumin excretion (UAER). Patients whose UAER < 20 µg/min belonged to normal albuminuria (NA) group. The ones whose UAER from 20 to 200 µg/min belonged to microalbuminuria (MA) group, and the others whose UAER ≥ 200 µg/min belonged to large albuminuia (LA) group. The clinical characteristics were then compared. The related factors of DN were analyzed.
(1) There were 1246 patients in NA group, 408 patients in MA group, and 104 patients in LA group. The constituent ratio of nephropathy was 29.1%. (2) The ages of NA group, MA group and LA group were (59.87 ± 12.77, 62.52 ± 12.74, 64.44 ± 12.74) years old, respectively, with body mass index (BMI) as (24.90 ± 3.42, 25.53 ± 4.00, 25.53 ± 3.91) kg/m(2) respectively; duration of diabetes as (8.39 ± 7.12, 10.77 ± 8.02, 12.84 ± 7.97) years; systolic blood pressure (SBP) as (133.42 ± 18.19, 142.72 ± 20.21, 151.12 ± 21.91) mm Hg; diastolic blood pressure as (78.75 ± 10.66, 80.79 ± 12.21, 83.33 ± 13.61) mm Hg; fasting blood sugar (FBS) as (8.25 ± 3.43, 9.02 ± 3.72, 9.22 ± 4.62) mmol/L; glycated hemoglobin (HbA1c) as (8.88 ± 2.10, 9.34 ± 2.36, 9.10 ± 2.36)%; uric acid (UA) as (288.04 ± 90.41, 307.23 ± 96.96, 374.28 ± 105.47) mmol/L; triglyceride as (1.72 ± 1.51, 2.06 ± 1.88, 1.94 ± 1.42) mmol/L, high density lipoprotein cholesterol as (1.08 ± 0.30, 1.02 ± 0.29, 1.07 ± 0.28) mmol/L; fasting insulin as (9.24 ± 9.02, 11.24 ± 9.74, 11.06 ± 9.29) µU/ml; fasting C peptide as (462.31 ± 289.94, 510.02 ± 350.08, 595.93 ± 445.86) pmol/L. There were significant differences between NA, MA and LA groups in all above items (P < 0.01 or P < 0.05). (3) Logistic regression analysis showed that DN were related with duration of diabetes, BMI, SBP, HbA1c, FBS, UA (OR values were 1.041, 1.055, 1.028, 1.116, 1.100, 1.004 respectively, P < 0.05 or P < 0.01).
It would be helpful to prevent and retard progression of DN that comprehensively controlling high blood glucose, hypertension, hyperuricemia and body weight of type 2 diabetic patients.
分析2型糖尿病患者糖尿病肾病（DN）的患病率及其相关因素。
回顾性分析2003年至2010年在北京医院住院的1758例2型糖尿病患者。根据尿白蛋白排泄率（UAER）分为三组。UAER<20μg/min的患者属于正常白蛋白尿（NA）组。UAER为20至200μg/min的患者属于微量白蛋白尿（MA）组，UAER≥200μg/min的其他患者属于大量白蛋白尿（LA）组。然后比较临床特征。分析DN的相关因素。
（1）NA组有1246例患者，MA组有408例患者，LA组有104例患者。肾病构成比为29.1%。（2）NA组、MA组和LA组的年龄分别为（59.87±12.77、62.52±12.74、64.44±12.74）岁，体重指数（BMI）分别为（24.90±3.42、25.53±4.00、25.53±3.91）kg/m²；糖尿病病程分别为（8.39±7.12、10.77±8.02、12.84±7.97）年；收缩压（SBP）分别为（133.42±18.19、142.72±20.21、151.12±21.91）mmHg；舒张压分别为（78.75±10.66、80.79±12.21、83.33±13.61）mmHg；空腹血糖（FBS）分别为（8.25±3.43、9.02±3.72、9.22±4.62）mmol/L；糖化血红蛋白（HbA1c）分别为（8.88±2.10、9.34±2.36、9.10±2.36）%；尿酸（UA）分别为（288.04±90.41、307.23±96.96、374.28±105.47）mmol/L；甘油三酯分别为（1.72±1.51、2.06±1.88、1.94±1.42）mmol/L，高密度脂蛋白胆固醇分别为（1.08±0.30、1.02±0.29、1.07±0.28）mmol/L；空腹胰岛素分别为（9.24±9.02、11.24±9.74、11.06±9.29）μU/ml；空腹C肽分别为（462.31±289.94、510.02±350.08、595.93±445.86）pmol/L。上述各项在NA、MA和LA组之间均有显著差异（P<0.01或P<0.05）。（3）Logistic回归分析显示，DN与糖尿病病程、BMI、SBP、HbA1c、FBS、UA相关（OR值分别为1.041、1.055、1.028、1.116、1.100、1.004，P<0.05或P<0.01）。
全面控制2型糖尿病患者的高血糖、高血压、高尿酸血症和体重，有助于预防和延缓DN的进展。
