CAJ | 학술논문

目的探究胰岛素抵抗与肥胖相关性肾病（O RG ）发病情况的相关性。方法选取2010年3月至2014年3月来本院进行常规肾功能检测的肥胖患者88例，依据检测结果将肾功能正常患者32例作为A组，肾病患者56例作为B组；并于8周后依据治疗效果将B组分为B1组32例（肾功能明显好转组）及B2组24例（肾功能未见好转组）。分别于患者体检时及8周治疗后复诊时检测各组患者的血脂相关指标、肾功能指标、血糖代谢指标及血压。结果 B组患者的总胆固醇（TC）、三酰甘油（TG）、24 h尿蛋白定量（24h‐UP）、血尿素氮（BUN）、空腹血糖（FBG）、餐后2 h血糖（2h‐PBG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA‐IR）及平均动脉压（MAP）均高于A组，B组患者的肌酐清除率（CCR）及高密度脂蛋白胆固醇（HDL‐C）均低于A组，差异有统计学意义（ P ＜0．05）；B1组患者的 TC、TG、24h‐UP、BUN、FBG、HOMA‐IR及MAP均低于B2组，B1组患者的CCR明显高于B2组，差异有统计学意义（ P ＜ 0．05）；通过 Pearson相关分析，患者的HOMA‐IR及MAP水平与24h‐UP及BUN呈明显正相关（ P ＜0．05），与CCR呈明显负相关（ r ＝－0．159，－0．368，P ＜0．05）。结论 HOMA‐IR及MAP的升高是导致ORG发病的重要原因，可为疾病的治疗指明新的方向。
목적 탐구이도소저항여비반상관성신병（O RG ）발병정황적상관성。방법 선취2010년3월지2014년3월래본원진행상규신공능검측적비반환자88례，의거검측결과장신공능정상환자32례작위A조，신병환자56례작위B조；병우8주후의거치료효과장B조분위B1조32례（신공능명현호전조）급B2조24례（신공능미견호전조）。분별우환자체검시급8주치료후복진시검측각조환자적혈지상관지표、신공능지표、혈당대사지표급혈압。결과 B조환자적총담고순（TC）、삼선감유（TG）、24 h뇨단백정량（24h‐UP）、혈뇨소담（BUN）、공복혈당（FBG）、찬후2 h혈당（2h‐PBG）、공복이도소（FINS）、이도소저항지수（HOMA‐IR）급평균동맥압（MAP）균고우A조，B조환자적기항청제솔（CCR）급고밀도지단백담고순（HDL‐C）균저우A조，차이유통계학의의（ P ＜0．05）；B1조환자적 TC、TG、24h‐UP、BUN、FBG、HOMA‐IR급MAP균저우B2조，B1조환자적CCR명현고우B2조，차이유통계학의의（ P ＜ 0．05）；통과 Pearson상관분석，환자적HOMA‐IR급MAP수평여24h‐UP급BUN정명현정상관（ P ＜0．05），여CCR정명현부상관（ r ＝－0．159，－0．368，P ＜0．05）。결론 HOMA‐IR급MAP적승고시도치ORG발병적중요원인，가위질병적치료지명신적방향。
Objective] To explore the correlation between insulin resistance and the incidence of obesity‐associated nephropathy(ORG) .[Methods]A total of 88 obese patients receiving routine renal function detection in our hospital from March 2010 to March 2014 were chosen .According to test results ,32 patients with nor‐mal renal function were taken as group A ,while 56 patients with kidney disease were taken as group B .Ac‐cording to treatment results after 8 weeks ,group B was divided into group B1( n=32 ,the group with signifi‐cantly improved renal function) and group B2( n=24 ,the group without obviously improved renal function) . The lipid related indicators ,renal function ,blood sugar and blood pressure of the two groups at medical exam‐ination and after 8 weeks of treatment were detected .[Results]Total cholesterol(TC) ,triglyceride(TG) ,24‐hour urinary protein excretion(24h‐UP) ,blood urea nitrogen(BUN) ,fasting blood glucose(FBG) ,2‐hour postprandial glucose(2h‐PBG) ,fasting insulin(FINS) ,insulin resistance index(HOMA‐IR) and mean arterial pressure (MAP) in group B were higher than those in group A ,while creatinine clearance rate (CCR) and high‐density lipoprotein cholesterol(HDL‐C) in group B were lower than those in group A ,and there were sig‐nificant differences( P <0 .05) .The TC ,TG ,24h‐UP ,BUN ,FBG ,HOMA‐IR and MAP in group B1 were lower than those in group B2 ,while CCR in group B1 was obviously higher than that in group B2 ,and there were significant differences( P <0 .05) .Pearson correlation analysis showed that HOMA‐IR and MAP of pa‐tients were positively correlated with 24h‐UP and BUN( P<0 .05) ,but negatively correlated with CCR( r =-0 .159 ,-0 .368 ,P <0 .05)[Conclusion]The increasing of HOMA‐IR and MAP is an important cause of ORG ,and may point out a new direction of the treatment of the disease .