实用检验医师杂志
實用檢驗醫師雜誌
실용검험의사잡지
Chinese Journal of Laboratory Pathologist
2014年
3期
137-141
,共5页
霍娟%郑萍%赵绍林%杨晋%吴惠毅
霍娟%鄭萍%趙紹林%楊晉%吳惠毅
곽연%정평%조소림%양진%오혜의
2型糖尿病%肾损伤%蛋白尿%血清25羟基维生素D%血尿酸%血肌酐%肾小球滤过率
2型糖尿病%腎損傷%蛋白尿%血清25羥基維生素D%血尿痠%血肌酐%腎小毬濾過率
2형당뇨병%신손상%단백뇨%혈청25간기유생소D%혈뇨산%혈기항%신소구려과솔
Type 2 diabetes%Kidney injury%Proteinuria%25-hydroxy vitamin D%Serum uric acid%Serum creatinine%Glomerular filtration rate
目的:探讨血清25羟基维生素D[25-hydroxy vitamin D,25-(OH)D]与2型糖尿病肾损伤的关系。方法选择2012年12月至2013年5月我院内分泌科住院的2型糖尿病患者148例,选择同期健康体检者50例作为对照组。依据尿白蛋白/肌酐(albumin/creatinine, Alb/Cr)将糖尿病患者分为正常蛋白尿组(Alb/Cr<30 mg/gCr)、微量蛋白尿组(Alb/Cr 30~299 mg/gCr)和大量蛋白尿组(Alb/Cr≥300 mg/gCr)。检测血清中25-(OH)D、空腹血糖(fasting plasma glucose, FPG)、糖化血红蛋白(hemoglobin A1c, HbA1c)、Cr、尿酸(uric acid, UA)、总胆固醇(total cholesterol, TCH)、甘油三酯(triglyc-eride, TG)、高密度脂蛋白(high density lipoprotein, HDL)、低密度脂蛋白(low density lipoprotein, LDL)。并对所得数据进行统计学分析。结果糖尿病患者的蛋白尿水平随着病程的延长而升高。三组糖尿病患者的病程差异有统计学意义(P<0.01)。三组患者的收缩压、Alb/Cr、FPG、HbA1c、TCH、TG、LDL、UA和血Cr均高于对照组,而肾小球滤过率(glomerular filtration rate, eGFR)和HDL低于对照组,差异均有统计学意义(P均<0.05)。大量蛋白尿组和微量蛋白尿组血清25-(OH)D水平较正常蛋白尿组和对照组明显降低,差异均有统计学意义(P均<0.01),而正常蛋白尿组与对照组比较差异无统计学意义。病程>10年的患者25-(OH)D水平显著低于病程5-10年及<5年的患者,差异均有统计学意义(P均<0.05)。Pearson相关分析结果表明,血清25-(OH)D与尿Alb/Cr、血Cr和UA均呈负相关,而与eGFR呈正相关(P 均<0.05)。多元logistic 回归分析结果表明,25-(OH)D与DN呈独立相关(β=-0.39,P<0.01),且OR为2.98。结论血清25-(OH)D是糖尿病肾脏损伤的独立危险因素,其水平降低可能导致糖尿病肾病的发生。
目的:探討血清25羥基維生素D[25-hydroxy vitamin D,25-(OH)D]與2型糖尿病腎損傷的關繫。方法選擇2012年12月至2013年5月我院內分泌科住院的2型糖尿病患者148例,選擇同期健康體檢者50例作為對照組。依據尿白蛋白/肌酐(albumin/creatinine, Alb/Cr)將糖尿病患者分為正常蛋白尿組(Alb/Cr<30 mg/gCr)、微量蛋白尿組(Alb/Cr 30~299 mg/gCr)和大量蛋白尿組(Alb/Cr≥300 mg/gCr)。檢測血清中25-(OH)D、空腹血糖(fasting plasma glucose, FPG)、糖化血紅蛋白(hemoglobin A1c, HbA1c)、Cr、尿痠(uric acid, UA)、總膽固醇(total cholesterol, TCH)、甘油三酯(triglyc-eride, TG)、高密度脂蛋白(high density lipoprotein, HDL)、低密度脂蛋白(low density lipoprotein, LDL)。併對所得數據進行統計學分析。結果糖尿病患者的蛋白尿水平隨著病程的延長而升高。三組糖尿病患者的病程差異有統計學意義(P<0.01)。三組患者的收縮壓、Alb/Cr、FPG、HbA1c、TCH、TG、LDL、UA和血Cr均高于對照組,而腎小毬濾過率(glomerular filtration rate, eGFR)和HDL低于對照組,差異均有統計學意義(P均<0.05)。大量蛋白尿組和微量蛋白尿組血清25-(OH)D水平較正常蛋白尿組和對照組明顯降低,差異均有統計學意義(P均<0.01),而正常蛋白尿組與對照組比較差異無統計學意義。病程>10年的患者25-(OH)D水平顯著低于病程5-10年及<5年的患者,差異均有統計學意義(P均<0.05)。Pearson相關分析結果錶明,血清25-(OH)D與尿Alb/Cr、血Cr和UA均呈負相關,而與eGFR呈正相關(P 均<0.05)。多元logistic 迴歸分析結果錶明,25-(OH)D與DN呈獨立相關(β=-0.39,P<0.01),且OR為2.98。結論血清25-(OH)D是糖尿病腎髒損傷的獨立危險因素,其水平降低可能導緻糖尿病腎病的髮生。
목적:탐토혈청25간기유생소D[25-hydroxy vitamin D,25-(OH)D]여2형당뇨병신손상적관계。방법선택2012년12월지2013년5월아원내분비과주원적2형당뇨병환자148례,선택동기건강체검자50례작위대조조。의거뇨백단백/기항(albumin/creatinine, Alb/Cr)장당뇨병환자분위정상단백뇨조(Alb/Cr<30 mg/gCr)、미량단백뇨조(Alb/Cr 30~299 mg/gCr)화대량단백뇨조(Alb/Cr≥300 mg/gCr)。검측혈청중25-(OH)D、공복혈당(fasting plasma glucose, FPG)、당화혈홍단백(hemoglobin A1c, HbA1c)、Cr、뇨산(uric acid, UA)、총담고순(total cholesterol, TCH)、감유삼지(triglyc-eride, TG)、고밀도지단백(high density lipoprotein, HDL)、저밀도지단백(low density lipoprotein, LDL)。병대소득수거진행통계학분석。결과당뇨병환자적단백뇨수평수착병정적연장이승고。삼조당뇨병환자적병정차이유통계학의의(P<0.01)。삼조환자적수축압、Alb/Cr、FPG、HbA1c、TCH、TG、LDL、UA화혈Cr균고우대조조,이신소구려과솔(glomerular filtration rate, eGFR)화HDL저우대조조,차이균유통계학의의(P균<0.05)。대량단백뇨조화미량단백뇨조혈청25-(OH)D수평교정상단백뇨조화대조조명현강저,차이균유통계학의의(P균<0.01),이정상단백뇨조여대조조비교차이무통계학의의。병정>10년적환자25-(OH)D수평현저저우병정5-10년급<5년적환자,차이균유통계학의의(P균<0.05)。Pearson상관분석결과표명,혈청25-(OH)D여뇨Alb/Cr、혈Cr화UA균정부상관,이여eGFR정정상관(P 균<0.05)。다원logistic 회귀분석결과표명,25-(OH)D여DN정독립상관(β=-0.39,P<0.01),차OR위2.98。결론혈청25-(OH)D시당뇨병신장손상적독립위험인소,기수평강저가능도치당뇨병신병적발생。
Objective To explore the relationship between serum 25-hydroxy vitamin D[25-(OH)D] level and kidney injury of type 2 diabetes. Methods 148 cases type 2 diabetes patients and 50 cases healthy people (control group) were collected in our hospital from December 2012 to May 2013. All patients were di-vided into normal proteinuria group [(albumin/creatinine, Alb/Cr)< 30 mg/gCr], microproteinuria group (Alb/Cr 30~299 mg/gCr) and massive proteinuria group(Alb/Cr≥300 mg/gCr). 25-(OH)D, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), uric acid (UA), total cholesterol (TCH), triglyceride (TG), high density lipoprotein(HDL) and low density lipoprotein(LDL) were detected. All data were analyzed statistically. Results Level of proteinuria in type 2 diabetes patients was increased along with the extension of course. There was statistical significance in the difference of pathogenesis among three disease groups (P<0.01). Lev-els of contractive pressure, Alb/Cr, FPG, HbA1c, TCH, TG, LDL, UA and serum Cr in type 2 diabetes pa-tients were all higher than that of control group, and levels of glomerular filtration rate (eGFR) and HDL were all lower than that of control group, the differences all had statistical significance (Pall<0.05). The levels of 25-(OH)D in massive proteinuria group and microproteinuria group were all lower than that of normal protein-uria group and control group, and the differences all had statistical significance (Pall<0.01). Level of 25-(OH)D in>10 years course patients was lower than that of 5-10 years course and<5 years course, and the differences all had statistical significance(Pall<0.05). Pearson relationship analysis showed that level of serum 25-(OH)D had negative correlation with levels of Alb/Cr, serum Cr and UA, but had positive correlation with eGFR(Pall<0.05). Multiple regression analysis showed that level of serum 25-(OH)D was independently cor-related with kidney injury of type 2 diabetes (β=-0.39,P<0.01), the OR was 2.98. Conclusion Serum 25-(OH)D is an independent risk factor to kidney injury of diabetes, which level reducing may lead to diabetic nephropathy.