CAJ | 학술논문

目的研究2型糖尿病(T2DM)患者尿白蛋白排泄(UAE)的主要影响因素. 方法观察T2DM并糖尿病肾病组(DN组)和非DN组(NDN组)各79例与健康对照组50名之间胰岛素样生长因子1(IGF-1)、空腹胰岛素(FINS)、空腹血糖(FBG)、胰岛素敏感指数(ISI)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-c)、低密度脂蛋白-胆固醇(LDL-c)、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)等因素的变异,并分析其与UAE的关系. 结果 (1)3组间性别、BMI差异均无显著意义(χ2=0.358,F=1.53,均P>0.05),DN组和NDN组间年龄、FBG、HbA1c差异均无显著意义(均P>0.05);(2)与NDN组和对照组比较, DN组SBP、DBP、IGF-1均显著升高(F为33.08、8.47和9.15,均P<0.01),TG显著升高、HDL-C明显降低(F为4.37和4.00,均P<0.05); (3) DN组FINS显著高于NDN组、ISI显著低于NDN组,两组FINS均显著高于健康对照组、ISI均显著低于健康对照组(F为29.41和37.77,均P<0.01).(4)以UAE为应变量,BMI、FINS、ISI、FBG、HbA1c、TC、TG、HDL-c、LDL-c为自变量,α为0.05,多元回归显示FINS、FBG和TG与UAE呈正相关(R2=0.171);自变量加入IGF-1后,IGF-1、FBG、FINS和TC与UAE呈正相关,HDL-c与UAE呈负相关(R2=0.331); 自变量再加入SBP、DBP时, SBP、IGF-1、FINS和FBG与UAE呈正相关(R2=0.408),余因素与UAE无显著相关. 结论 IGF-1、血压、血糖以及胰岛素水平等是UAE的主要影响因素,血脂次之, 并与DN的发生发展密切相关.
목적연구2형당뇨병(T2DM)환자뇨백단백배설(UAE)적주요영향인소. 방법관찰T2DM병당뇨병신병조(DN조)화비DN조(NDN조)각79례여건강대조조50명지간이도소양생장인자1(IGF-1)、공복이도소(FINS)、공복혈당(FBG)、이도소민감지수(ISI)、당화혈홍단백(HbA1c)、총담고순(TC)、감유삼지(TG)、고밀도지단백-담고순(HDL-c)、저밀도지단백-담고순(LDL-c)、수축압(SBP)、서장압(DBP)、체중지수(BMI)등인소적변이,병분석기여UAE적관계. 결과 (1)3조간성별、BMI차이균무현저의의(χ2=0.358,F=1.53,균P>0.05),DN조화NDN조간년령、FBG、HbA1c차이균무현저의의(균P>0.05);(2)여NDN조화대조조비교, DN조SBP、DBP、IGF-1균현저승고(F위33.08、8.47화9.15,균P<0.01),TG현저승고、HDL-C명현강저(F위4.37화4.00,균P<0.05); (3) DN조FINS현저고우NDN조、ISI현저저우NDN조,량조FINS균현저고우건강대조조、ISI균현저저우건강대조조(F위29.41화37.77,균P<0.01).(4)이UAE위응변량,BMI、FINS、ISI、FBG、HbA1c、TC、TG、HDL-c、LDL-c위자변량,α위0.05,다원회귀현시FINS、FBG화TG여UAE정정상관(R2=0.171);자변량가입IGF-1후,IGF-1、FBG、FINS화TC여UAE정정상관,HDL-c여UAE정부상관(R2=0.331); 자변량재가입SBP、DBP시, SBP、IGF-1、FINS화FBG여UAE정정상관(R2=0.408),여인소여UAE무현저상관. 결론 IGF-1、혈압、혈당이급이도소수평등시UAE적주요영향인소,혈지차지, 병여DN적발생발전밀절상관.
Objective To study the relational factors influening urinary albumin excretion (UAE) in type 2 diabetes mellitus(T2DM). Methods Insulin-like growth factor 1(IGF-1), fasting insulin(FINS), fasting blood glucose(FBG), insulin sensitivity index(ISI=1/FBG×FINS), HbA 1c,total cholesterol(TC), triglycerides (TG),HDL-c,LDL-c, systolic blood pressure(SBP),diastolic blood pressure(DBP), body mass index(BMI) in 79 case with diabetic nephropathy (DN), 79 case with non diabetic nephropathy( non-DN) and 50 control were observed.The relationship between these markers and UAE was analyzed. Results (1)Sex and BMI were not of significant difference among all the groups(χ2 was 0.358, F was 1.53, all P>0.05). Age and FBG and Hb 1Ac were not of significant difference between DN and non-DN (P>0.05). (2) The level of SBP,DBP, IGF-1, TG and FINS were higher in DN than the in others group (F was 33.08, 8.47, 9.15, 29.41 and 4.37 respectively, all P<0.01) .The level of HDL-c and ISI were lower in DN than in the other groups (F was 4.00 and 37.77, all P<0.01). FINS in DN or NDN were higher than in control but ISI were lower(all P<0.01).3. Multiple Linear regression showed(α equal 0.05) dependent variable was UAE. Independent variables were BMI?FINS?ISI?FBG?HbA 1c?TC?TG?HDL-c and LDL-c. UAE was positively correlated with FINS,FBG and TG (R2=0.171). When adding independent variable and IGF-1,UAE was positively correlated with IGF-1, FINS,FBG and TC. UAE was negatively correlated with HDL-c (R2=0.331).When independent variable was added to SBP and DBP, UAE was positively correlated with SBP, IGF-1, FINS and FBG (R2 was 0.408). Conclusion IGF-1, blood pressure, blood glucose and insulin were major influencing factors of UAE in type 2 DM. Blood lipid was the next. They may be related to occurrence and development of DN.