分析 2 型糖尿病患者尿白蛋白排泄率（UAER）与肾小球滤过率（eGFR）的相关性及 eGFR 下降的危险因素。
To analyse the correlation between UAER and eGFR and the risk factors for reducing eGFR in patients with type 2 diabetes.
机构信息
Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Workers' Stadium South Road, Hujialou Street, Chaoyang District, Beijing, 100020, China.
出版信息
BMC Endocr Disord. 2024 Oct 28;24(1):228. doi: 10.1186/s12902-024-01761-8.
OBJECTIVE
To analyse the correlation between urinary albumin excretion rate (UAER) and estimated glomerular filtration rate (eGFR) and the risk factors for reducing eGFR in patients with type 2 diabetes mellitus (T2DM).
METHODS
A total of 431 T2DM patients admitted between January 2019 and March 2020 were selected and divided into two groups according to eGFR level. Comparing the differences between baseline data and clinical indicators, multivariate logistic regression was used to analyse the risk factors of eGFR reduction and to analyse the association between UAER and eGFR.
RESULTS
In total, 167 patients were included in the study group and 264 patients were included in the conventional group. The study group participants were older, had longer diabetes duration, and had higher fatty liver, peripheral vascular disease (PVD), hypertension prevalence, and mean body mass index (P < 0.05). The levels of various indicators were lower than those of the conventional group (P < 0. 05). Additionally, PVD, nocturnal systolic blood pressure, fatty liver, and beta-2-microglobulin (β 2-MG) were independent risk factors for eGFR decline, with high density lipoprotein (HDL) and fasting C-peptide (CP) as protective factors. There was no obvious correlation between UAER and eGFR.
CONCLUSION
Peripheral vascular disease, systolic blood pressure, fatty liver, and beta-2-microglobulin are risk factors for decreased eGFR levels in patients with T2DM, which should be applied for control DKD. HDL and fasting CP have important effects on maintaining eGFR, and blood pressure and fasting CP can be used as new targets for subsequent diabetic kidney disease treatment.
目的
分析 2 型糖尿病（T2DM）患者尿白蛋白排泄率（UAER）与估算肾小球滤过率（eGFR）的相关性及 eGFR 降低的危险因素。
方法
选取 2019 年 1 月至 2020 年 3 月期间收治的 431 例 T2DM 患者，根据 eGFR 水平分为两组。比较两组基线资料及临床指标的差异，采用多因素 logistic 回归分析 eGFR 降低的危险因素，并分析 UAER 与 eGFR 的相关性。
结果
共纳入研究组 167 例，常规组 264 例。研究组患者年龄较大，糖尿病病程较长，且脂肪肝、外周血管疾病（PVD）、高血压患病率、平均体质量指数较高（P<0.05）。各项指标水平均低于常规组（P<0.05）。此外，PVD、夜间收缩压、脂肪肝、β 2-微球蛋白（β 2-MG）是 eGFR 下降的独立危险因素，高密度脂蛋白（HDL）和空腹 C 肽（CP）是保护因素。UAER 与 eGFR 无明显相关性。
结论
PVD、收缩压、脂肪肝和β 2-MG 是 T2DM 患者 eGFR 降低的危险因素，应积极控制 DKD。HDL 和空腹 CP 对维持 eGFR 有重要作用，血压和空腹 CP 可作为后续糖尿病肾病治疗的新靶点。
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