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2型糖尿病中的微量白蛋白尿、肾病的其他标志物及生化紊乱:关系与决定因素

Microalbuminuria, Other Markers of Nephropathy and Biochemical Derangementsin Type 2 Diabetes Mellitus: Relationships and Determinants.

作者信息

Idowu Ademola A, Ajose Abiodun O, Adedeji Adeoye T, Adegoke Adegbola O, Jimoh Kayode A

机构信息

Department of Chemical Pathology, Ekiti State University, Ado Ekiti, Ekiti State, Nigeria.

Department of Chemical Pathology, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria.

出版信息

Ghana Med J. 2017 Jun;51(2):56-63.


DOI:
PMID:28955101
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5611905/
Abstract

BACKGROUND: Microalbuminuria is an early indicator of Diabetic nephropathy and cerebrovascular disease. OBJECTIVE: To evaluate relationships between microalbuminuria and other predictors of morbidity and mortality in type 2 DM. METHODS: Fifty type 2 diabetic subjects were recruited each for three groups separated by disease durations. Thirty non-diabetic subjects were recruited to control each group. Urine albumin-to-creatinine ratio (ACR) was estimated. Fasting plasma glucose (FPG), serum creatinine, urea, total cholesterol (TC), triglycerides (TG), high-and low density lipoprotein (HDL, LDL) were measured. RESULTS: The diabetics with longest disease duration of >10 years were the oldest (65.86±1.71), had highest systolic BP (147.12±3.39mmHg) and least BMI (27.20±0.71Kg/m); they had poorest lipid control (TC:5.54±0.26mmol/L), though with the least TG (0.97±0.09mmol/L); they also had the most severe microalbuminuria (33.63±8.03g/L) and ACR (65.85±10.38mg/gm). Patients with diabetes of 5-10 years had the poorest glycaemic control:FPG-7.82±0.47mmol/L; HbA1c-13.09±0.74%). Significant negative correlations exist between microalbuminuria, HBA1c(r=-2.28, p=0.028) and serum creatinine(r=-2.11, p=0.042) in patients with 5-10 years disease; a positive correlation between the ACR and TC(r=1.00,p<0.01) in those with >10 years disease. In multivariate analysis, independent predictors of microalbuminuria were disease duration (OR 2.2, p< 0.001); HBA1c (OR 7.3, p=0.02); LDL/HDL ratio (OR 13.4, p< 0.001). CONCLUSION: The severity and progression of albuminuria are associated with longer duration of diabetes and poor glycaemic control. Significant relationships exist between ACR and HBA1c, TC, HDL-C, TG, creatinine. Disease duration, ethnicity, HBA1c, TC, TG, HDL-C and LDL/HDL ratio are independent predictors of albuminuria. FUNDING: None declared.

摘要

背景:微量白蛋白尿是糖尿病肾病和脑血管疾病的早期指标。 目的:评估2型糖尿病患者微量白蛋白尿与其他发病和死亡预测因素之间的关系。 方法:根据病程将50名2型糖尿病患者分为三组,每组50人。招募30名非糖尿病患者作为每组的对照。估算尿白蛋白与肌酐比值(ACR)。测量空腹血糖(FPG)、血清肌酐、尿素、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白和低密度脂蛋白(HDL、LDL)。 结果:病程最长>10年的糖尿病患者年龄最大(65.86±1.71岁),收缩压最高(147.12±3.39mmHg),体重指数最低(27.20±0.71Kg/m);他们的血脂控制最差(TC:5.54±0.26mmol/L),不过甘油三酯最低(0.97±0.09mmol/L);他们的微量白蛋白尿最严重(33.63±8.03g/L),ACR最高(65.85±10.38mg/gm)。病程5至10年的糖尿病患者血糖控制最差:FPG为7.82±0.47mmol/L;糖化血红蛋白为13.09±0.74%。病程5至10年的患者中,微量白蛋白尿与糖化血红蛋白(r=-2.28,p=0.028)和血清肌酐(r=-2.11,p=0.042)之间存在显著负相关;病程>10年的患者中,ACR与TC之间存在正相关(r=1.00,p<0.01)。在多变量分析中,微量白蛋白尿的独立预测因素为病程(OR=2.2,p<0.001);糖化血红蛋白(OR=7.3,p=0.02);低密度脂蛋白/高密度脂蛋白比值(OR=13.4,p<0.001)。 结论:蛋白尿的严重程度和进展与糖尿病病程延长和血糖控制不佳有关。ACR与糖化血红蛋白、TC、高密度脂蛋白胆固醇、甘油三酯、肌酐之间存在显著关系。病程、种族、糖化血红蛋白、TC、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白/高密度脂蛋白比值是蛋白尿的独立预测因素。 资金来源:未声明。

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