中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2012年
5期
402-405
,共4页
黄虹%吴天凤%江缨%郑和昕%袁放%俞晓映
黃虹%吳天鳳%江纓%鄭和昕%袁放%俞曉映
황홍%오천봉%강영%정화흔%원방%유효영
糖尿病肾病%纤维蛋白原%胆固醇,HDL
糖尿病腎病%纖維蛋白原%膽固醇,HDL
당뇨병신병%섬유단백원%담고순,HDL
Diabetic nephropathies%Fibrinogen%Cholesterol,HDL
目的 探讨老年2型糖尿病患者血浆纤维蛋白原(FIB)及非高密度脂蛋白胆固醇(non- HDL-C)水平与糖尿病肾病的相关性. 方法 将152例老年2型糖尿病患者(年龄≥60岁)根据24 h尿白蛋白排泄率,分为正常白蛋白尿(89例)、异常白蛋白尿两组(63例),分别测定体质指数(BMI)、收缩压、舒张压、空腹血糖(FPG)、餐后血糖(2 hPG)、糖化血红蛋白(HbA1c)、血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、FIB及24 h尿白蛋白量(UAER)等,并计算non-HDL-C与估算肾小球滤过率(eGFR). 结果 异常白蛋白尿组患者的年龄、并存高血压病史患者数、收缩压、Scr、FIB分别为(74.6±7.3)岁、57例(90.5％)、(146.8±23.2)mm H g、(1.0±0.7)μmol/L、(4.8±1.5)g/L,与正常白蛋白尿组(71.6±7.2)岁、59例(66.3％)、(137.7±19.2) mm Hg、(0.8±0.3)μmol/L、(4.2±1.3)g/L比较均明显升高(t=-2.536、-2.656、-2.474、-2.857,x2=11.936,均P＜0.05);而异常白蛋白尿组患者eGFR( 68.5±31.2)ml· min 1·1.73 m-2,比正常白蛋白尿组(81.4±25.9)ml·min-1·1.73 m-2明显下降(t=2.791,P＜0.05).异常白蛋白尿患者中FIB升高患者数中(45例,71.4％),明显高于FIB正常患者数(18例,28.6％)(X2=8.085,P=0.004)；且FIB升高组(88例)的异常白蛋白尿患者的eGFR(62.6±30.5)ml·min-1·1.73 m-2,明显低于FIB正常组(64例)(83.2±28.7)ml· min-1·1.73m 2(t=2.459,P=0.017).Pearson相关分析显示,UAER与non- HDL-C、TG、TC、FIB均呈正相关(r=0.276、0.268、0.243、0.176,均P＜0.05)；进一步多元逐步回归分析结果显示,FIB是影响老年2型糖尿病患者白蛋白尿的独立危险因素(标准化偏回归系数β=0.166,P＜0.05). 结论 FIB、non-HDL-C水平的升高与老年人2型糖尿病肾病的发生密切相关.
目的 探討老年2型糖尿病患者血漿纖維蛋白原(FIB)及非高密度脂蛋白膽固醇(non- HDL-C)水平與糖尿病腎病的相關性. 方法 將152例老年2型糖尿病患者(年齡≥60歲)根據24 h尿白蛋白排洩率,分為正常白蛋白尿(89例)、異常白蛋白尿兩組(63例),分彆測定體質指數(BMI)、收縮壓、舒張壓、空腹血糖(FPG)、餐後血糖(2 hPG)、糖化血紅蛋白(HbA1c)、血清三酰甘油(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、FIB及24 h尿白蛋白量(UAER)等,併計算non-HDL-C與估算腎小毬濾過率(eGFR). 結果 異常白蛋白尿組患者的年齡、併存高血壓病史患者數、收縮壓、Scr、FIB分彆為(74.6±7.3)歲、57例(90.5％)、(146.8±23.2)mm H g、(1.0±0.7)μmol/L、(4.8±1.5)g/L,與正常白蛋白尿組(71.6±7.2)歲、59例(66.3％)、(137.7±19.2) mm Hg、(0.8±0.3)μmol/L、(4.2±1.3)g/L比較均明顯升高(t=-2.536、-2.656、-2.474、-2.857,x2=11.936,均P＜0.05);而異常白蛋白尿組患者eGFR( 68.5±31.2)ml· min 1·1.73 m-2,比正常白蛋白尿組(81.4±25.9)ml·min-1·1.73 m-2明顯下降(t=2.791,P＜0.05).異常白蛋白尿患者中FIB升高患者數中(45例,71.4％),明顯高于FIB正常患者數(18例,28.6％)(X2=8.085,P=0.004)；且FIB升高組(88例)的異常白蛋白尿患者的eGFR(62.6±30.5)ml·min-1·1.73 m-2,明顯低于FIB正常組(64例)(83.2±28.7)ml· min-1·1.73m 2(t=2.459,P=0.017).Pearson相關分析顯示,UAER與non- HDL-C、TG、TC、FIB均呈正相關(r=0.276、0.268、0.243、0.176,均P＜0.05)；進一步多元逐步迴歸分析結果顯示,FIB是影響老年2型糖尿病患者白蛋白尿的獨立危險因素(標準化偏迴歸繫數β=0.166,P＜0.05). 結論 FIB、non-HDL-C水平的升高與老年人2型糖尿病腎病的髮生密切相關.
목적 탐토노년2형당뇨병환자혈장섬유단백원(FIB)급비고밀도지단백담고순(non- HDL-C)수평여당뇨병신병적상관성. 방법 장152례노년2형당뇨병환자(년령≥60세)근거24 h뇨백단백배설솔,분위정상백단백뇨(89례)、이상백단백뇨량조(63례),분별측정체질지수(BMI)、수축압、서장압、공복혈당(FPG)、찬후혈당(2 hPG)、당화혈홍단백(HbA1c)、혈청삼선감유(TG)、총담고순(TC)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、FIB급24 h뇨백단백량(UAER)등,병계산non-HDL-C여고산신소구려과솔(eGFR). 결과 이상백단백뇨조환자적년령、병존고혈압병사환자수、수축압、Scr、FIB분별위(74.6±7.3)세、57례(90.5％)、(146.8±23.2)mm H g、(1.0±0.7)μmol/L、(4.8±1.5)g/L,여정상백단백뇨조(71.6±7.2)세、59례(66.3％)、(137.7±19.2) mm Hg、(0.8±0.3)μmol/L、(4.2±1.3)g/L비교균명현승고(t=-2.536、-2.656、-2.474、-2.857,x2=11.936,균P＜0.05);이이상백단백뇨조환자eGFR( 68.5±31.2)ml· min 1·1.73 m-2,비정상백단백뇨조(81.4±25.9)ml·min-1·1.73 m-2명현하강(t=2.791,P＜0.05).이상백단백뇨환자중FIB승고환자수중(45례,71.4％),명현고우FIB정상환자수(18례,28.6％)(X2=8.085,P=0.004)；차FIB승고조(88례)적이상백단백뇨환자적eGFR(62.6±30.5)ml·min-1·1.73 m-2,명현저우FIB정상조(64례)(83.2±28.7)ml· min-1·1.73m 2(t=2.459,P=0.017).Pearson상관분석현시,UAER여non- HDL-C、TG、TC、FIB균정정상관(r=0.276、0.268、0.243、0.176,균P＜0.05)；진일보다원축보회귀분석결과현시,FIB시영향노년2형당뇨병환자백단백뇨적독립위험인소(표준화편회귀계수β=0.166,P＜0.05). 결론 FIB、non-HDL-C수평적승고여노년인2형당뇨병신병적발생밀절상관.
Objective To investigate the relationship of plasma fibrinogen (FIB) and non-highdensity lipoprotein cholesterol (non-HDL-C) with diabetic nephropathy in the elderly with type 2 diabetes. Methods Totally 152 patients (aged 60 years and over) with type 2 diabetics were divided into normal albuminuria (UAER＜30 mg/24 h,n=89) and abnormal albuminuria (UAER≥ 30 mg/24 h,n=63) groups,with high FIB (＞4.00 g/L,n=88) and normal FTB (2.00-4.00 g/L,n=64)sub-groups.The body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),postprandial blood glucose (2 hPG),glycated hemoglobin (HbAlc),serum triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),FIB and 24-hour urinary albumin excretion rate (UAER) were measured.The non-HDL-C and estimated glomerular filtration rate (eGFR) were calculated. Results Compared with normal albuminuria group,the values of age,hypertension rate,SBP,Scr and FIB in abnormal albuminuria group were increased [(74.6 ± 7.3) years,57 cases (90.5％),(146.8±23.2)mm Hg,(1.010.7)μmol/L,(4.8±1.5)g/Lvs.(71.6±7.2)years,59 cases (66.3％),(137.7±19.2) mm Hg,(0.8±0.3)μmol/L,(4.2±1.3)g/L,t=-2.536,-2.656,- 2.474,-2.857,x2 =11.936,all P＜0.05] while eGFR was significantly decreased [(68.5±31.2)ml · min-1 · 1.73 m-2 vs.(81.4±25.9)ml · min-1 · 1.73m-2,t=2.791,P＜0.05].The number of patients with high FIB was enhanced in abnormal albuminuria group than normal albuminuria group[45 cases (71.4％) vs. 18 cases (28.6％),x2 =8.085,P=0.004]. The proportion of abnormal albuminuria in high FIB group was lower than that in normal FIB group [(62.6±30.5) ml· min-1 · 1.73 m-2 vs.(83.2±28.7) ml· min-1 · 1.73 m 2,t=2.459,P=0.017].The Pearson analysis revealed that UAER was positively correlated with FIB,TG,TC and non-HDL-C (r=0.276,0.268,0.243,0.176,all P＜0.05).Stepwise regressive analysis showed that FIB was an independent risk factors of urinary albumin in the elderly with type 2 diabetes.Conclusions Higher levels of FIB and non-HDL-C are well correlated with diabetic nephropathy in the elderly with type 2 diabetes.
