CAJ | 학술논문

目的探讨血脂异常对代谢综合征( metabolic syndrome, MS)早期肾功损害的影响.方法将 357例患者分为高血压组( EH)、糖尿病组( DM)和 MS组,将 3组依血脂水平变化分为血脂正常和异常 2个亚组,亚组间的血压、血糖和病程无显著差别,分别比较每组血脂正常和血脂异常组的肾功能变化,并分析血脂和肾功能的关系.结果 MS组中,血脂异常组 24 h微量蛋白尿( MA,mg/24 h)显著高于血脂正常组 [(66± 3) /( 45± 4), t=- 3.904, P< 0.01],内生肌酐清除率 (Ccr, mL/min)显著低于血脂正常组 [(57± 3) /( 72± 4), t=- 3.838, P< 0.01];而 EH和 DM组的 MA和 Ccr水平在血脂正常和异常组中差异无显著性意义.相关分析表明, MS组中 TC, LDL, ApoB与 MA和 Ccr有显著相关,其中 TC对 MA和 Ccr影响最大 (MA: r=0.3807, P< 0.01; Ccr: r=0.3807, P< 0.05); 而 EH和 DM组中 TC,LDL,ApoB与 MA和 Ccr 无显著相关.结论与 EH和 DM相比,在血压和血糖相似的情况下,血脂异常是致 MS肾功能损害的重要因素,早期介入康复方法进行积极的调脂治疗对保护 MS的肾功能有临床意义.
목적탐토혈지이상대대사종합정( metabolic syndrome, MS)조기신공손해적영향.방법장 357례환자분위고혈압조( EH)、당뇨병조( DM)화 MS조,장 3조의혈지수평변화분위혈지정상화이상 2개아조,아조간적혈압、혈당화병정무현저차별,분별비교매조혈지정상화혈지이상조적신공능변화,병분석혈지화신공능적관계.결과 MS조중,혈지이상조 24 h미량단백뇨( MA,mg/24 h)현저고우혈지정상조 [(66± 3) /( 45± 4), t=- 3.904, P< 0.01],내생기항청제솔 (Ccr, mL/min)현저저우혈지정상조 [(57± 3) /( 72± 4), t=- 3.838, P< 0.01];이 EH화 DM조적 MA화 Ccr수평재혈지정상화이상조중차이무현저성의의.상관분석표명, MS조중 TC, LDL, ApoB여 MA화 Ccr유현저상관,기중 TC대 MA화 Ccr영향최대 (MA: r=0.3807, P< 0.01; Ccr: r=0.3807, P< 0.05); 이 EH화 DM조중 TC,LDL,ApoB여 MA화 Ccr 무현저상관.결론여 EH화 DM상비,재혈압화혈당상사적정황하,혈지이상시치 MS신공능손해적중요인소,조기개입강복방법진행적겁적조지치료대보호 MS적신공능유림상의의.
Aim To explore the influence of dyslipidemia on early renal functional lesions in patients with metabolic syndrome(MS).Methods 109 cases with essential hypertension (56 males and 53 females, EH group), 73 cases with diabetes mellitus (39 males and 34 females, DM group) and 175 cases with metabolic syndrome (87 males and 88 females, MS group) were respectively divided into two subgroups: normal lipid groups and dyslipidemia groups according to the serum total cholesterol(TC), triglycerides(TG), low density lipoprotein(LDL), and apolipoprotein B(Apo B) levels. The changes of renal function were observed and comparde between the subgroups of normal and dyslipidemia respectively.Results In the MS group, the concentration of microalbuminuria(MA) in the dyslipidemia group was(66± 3) mg within 24 hours, significantly higher than that of the normal group [(45± 4)mg,t=- 3.904,P< 0.01]; the endogenous creatinine clearance rate (Ccr) was (57± 3) mL/min in the dyslipidemia group, significantly lower than that in the normal group[(72± 4)mL/min,t=- 3.838,P< 0.01].But in the DM and EH groups,the concentrations of MA and Ccr were insignificantly different between the normal and dyslipidemia groups respectively. The correlation analysis showed that TC, LDL and ApoB only in the MS group were significantly related with MA and Ccr, and the TC played a most important role in MA and Ccr(r=0.3807, P< 0.01; r=0.3807, P< 0.05).Conclusion Dyslipidemia is one of the important factors inducing renal dysfunction in patients with MS when blood pressure and glucose are controlled at the same levels. Thus, serum lipid lowering therapy may be necessary to prevent deterioration of renal function in patients with metabolic syndrome.