CAJ | 학술논문

【目的】探讨2型糖尿病（T2DM）合并糖尿病肾病早期（EDN）的危险因素，为糖尿病肾病（DN）的早期防治提供科学依据。【方法】将566例T2DM患者按24 h尿微量白蛋白水平分为DN早期组（DN组，尿白蛋白30～300 mg/24 h）和单纯2型糖尿病组（DM组，尿白蛋白＜30 mg/24 h），比较两组在高血压病史、脂肪肝病病史、吸烟史及糖尿病病程、体质量指数（BMI）、甘油三酯（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）、尿酸（UA）、糖化血红蛋白（HBA1C）、空腹C肽（FCP）、半小时C肽（0．5 hPCP）、2 hC肽（2 hPCP）等方面的差异，并进行比较分析。【结果】DN组和 DM组病程、合并高血压比例、吸烟比例、BMI、HDL-C、TG、UA水平相比较差异有显著性（P＜0．05），脂肪肝发生率、HBA1C、FCP、0．5 hPCP、2hPCP、LDL-C水平相比较差异无显著性（P＞0．05）。DN组的病程、BMI、TG、UA水平较高，HDL-C水平较低。Logistical 回归分析显示，糖尿病病程、合并高血压、高 BMI 及高 LDL-C 是 DN 的影响因素。【结论】糖尿病病程长、合并高血压、高 BMI及高 LDL-C是早期 DN的危险因素，糖尿病病人应戒烟，严格控制血压、血糖和体质量，定期监测尿酸、血脂，积极纠正脂代谢紊乱，可预防DN的发生和发展。
【목적】탐토2형당뇨병（T2DM）합병당뇨병신병조기（EDN）적위험인소，위당뇨병신병（DN）적조기방치제공과학의거。【방법】장566례T2DM환자안24 h뇨미량백단백수평분위DN조기조（DN조，뇨백단백30～300 mg/24 h）화단순2형당뇨병조（DM조，뇨백단백＜30 mg/24 h），비교량조재고혈압병사、지방간병병사、흡연사급당뇨병병정、체질량지수（BMI）、감유삼지（TG）、총담고순（TC）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、뇨산（UA）、당화혈홍단백（HBA1C）、공복C태（FCP）、반소시C태（0．5 hPCP）、2 hC태（2 hPCP）등방면적차이，병진행비교분석。【결과】DN조화 DM조병정、합병고혈압비례、흡연비례、BMI、HDL-C、TG、UA수평상비교차이유현저성（P＜0．05），지방간발생솔、HBA1C、FCP、0．5 hPCP、2hPCP、LDL-C수평상비교차이무현저성（P＞0．05）。DN조적병정、BMI、TG、UA수평교고，HDL-C수평교저。Logistical 회귀분석현시，당뇨병병정、합병고혈압、고 BMI 급고 LDL-C 시 DN 적영향인소。【결론】당뇨병병정장、합병고혈압、고 BMI급고 LDL-C시조기 DN적위험인소，당뇨병병인응계연，엄격공제혈압、혈당화체질량，정기감측뇨산、혈지，적겁규정지대사문란，가예방DN적발생화발전。
[Objective]To explore the risk factors of early diabetic nephropathy(EDN)in type 2 diabetes mellitus(T2DM)in order to provide the scientific evidence for early prevention and treatment of type 2 diabetic nephropathy (DN).[Methods]According to 24h urinary albumin level,566 T2DM patients were divided into EDN group(EN group,urinary albumin was 30~300mg/24h)and simple T2DM group(DM group,urinary albumin<30mg/24 h).The history of hypertension,fatty liver disease and smoking,the duration of diabetes mellitus,body mass index(BMI),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholester-ol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),glucosylated hemoglobin(HBA1C), fasting C-peptide(FCP),half an hour C-peptide(0.5hPCP)and 2 hour C-peptide(2hPCP)were compared be-tween two groups.[Results]There were significant differences in duration,the percentage of hypertension , the percentage of smoking,BMI,HDL-C,TG and UA levels between EN group and DM group(P<0.05), but there was no significant difference in the incidence of fatty liver disease,HBA1C,FCP,0.5hPCP,2hPCP and LDL-C between two groups(P>0.05).The duration,BMI,TG and UA in EN group were lower.Lo-gistical regression analysis showed that the duration of diabetes mellitus,the hypertension,high BMI and high LDL-C were the influencing factors of DN.[Conclusion]Long duration of diabetes mellitus,hypertension, high BMI and high LDL-C are the risk factors of EDN.Diabetic patients should stop smoking,strictly control blood pressure,blood sugar and body weight,regularly monitor UA and blood lipids and actively correct lipid metabolism disorders in order to prevent the occurrence and development of DN.