中国医药
中國醫藥
중국의약
CHINA MEDICINE
2015年
2期
200-203
,共4页
糖尿病,2型%尿酸%肾小球滤过率%尿白蛋白
糖尿病,2型%尿痠%腎小毬濾過率%尿白蛋白
당뇨병,2형%뇨산%신소구려과솔%뇨백단백
Diabetes mellitus,type 2%Uric acid%Glomerular filtration rate%Urinary albumin
目的 探讨2型糖尿病患者血尿酸水平与肾小球滤过率(GFR)、尿微量白蛋白(mALB)排出量的关系.方法 将686例2型糖尿病患者按GFR水平分成3组,A组:GFR≥90 ml/(min· 1.73 m2),191例;B组:60 ml/(min· 1.73 m2)≤GFR ＜90 ml/(min· 1.73 m2),383例;C组:GFR ＜60 ml/(min· 1.73 m2),112例;分析不同肾功能状态组的临床特征.再将尿酸值从小到大排序,按四分位数分成4组,尿酸＜214.7 μmol/L组,171例;尿酸214.7 ～271.6 μmol/L组,172例;尿酸271.7 ～ 329.4 μmol/L组,172例;尿酸＞ 329.4 μmol/L组,171例;分析不同血尿酸水平患者的GFR、24 h尿mALB(mALB/24 h)的变化及相关性.结果 按GFR水平分成的A、B、C组患者的年龄、病史、肌酐、尿酸、总胆固醇、mALB/24 h的差异均有统计学意义[年龄:(53±13)、(61±11)、(68±9)岁,病史:(6.0±2.3)、(7.9±3.3)、(14.0±4.5)年,肌酐:(57±9)、(62±16)、(137±83) μmol/L,尿酸:(258±83)、(282±80)、(345±96) μmol/L,总胆固醇:(5.0±1.1)、(5.3±1.2)、(5.7±1.4) mmol/L,ln(mALB/24 h):(1.9±0.8)、(2.0±0.6)、(2.6±0.9)](P＜0.0l或P＜0.05).根据尿酸水平的分组并进行Pearson相关分析表明,尿酸与GFR呈负相关(r=-0.248,P ＜0.01);尿酸与mALB/24 h呈正相关(r=0.254,P ＜0.01);GFR与mALB/24 h呈负相关(r=-0.352,P ＜0.01).Logistic回归分析结果表明,尿酸、年龄、病史、总胆固醇是肾功能不全的危险因素[比值比(OR) =1.013、OR=1.093、OR=1.097、OR=1.369,P ＜0.01或P＜0.05];尿酸、年龄、总胆固醇是异常蛋白尿的危险因素(OR=1.004 、OR=1.029、OR=1.073,均P＜0.05).结论 2型糖尿病患者的肾小球滤过率及尿mALB排出量与血尿酸相关,且血尿酸是异常蛋白尿和肾功能不全的危险因素.
目的 探討2型糖尿病患者血尿痠水平與腎小毬濾過率(GFR)、尿微量白蛋白(mALB)排齣量的關繫.方法 將686例2型糖尿病患者按GFR水平分成3組,A組:GFR≥90 ml/(min· 1.73 m2),191例;B組:60 ml/(min· 1.73 m2)≤GFR ＜90 ml/(min· 1.73 m2),383例;C組:GFR ＜60 ml/(min· 1.73 m2),112例;分析不同腎功能狀態組的臨床特徵.再將尿痠值從小到大排序,按四分位數分成4組,尿痠＜214.7 μmol/L組,171例;尿痠214.7 ～271.6 μmol/L組,172例;尿痠271.7 ～ 329.4 μmol/L組,172例;尿痠＞ 329.4 μmol/L組,171例;分析不同血尿痠水平患者的GFR、24 h尿mALB(mALB/24 h)的變化及相關性.結果 按GFR水平分成的A、B、C組患者的年齡、病史、肌酐、尿痠、總膽固醇、mALB/24 h的差異均有統計學意義[年齡:(53±13)、(61±11)、(68±9)歲,病史:(6.0±2.3)、(7.9±3.3)、(14.0±4.5)年,肌酐:(57±9)、(62±16)、(137±83) μmol/L,尿痠:(258±83)、(282±80)、(345±96) μmol/L,總膽固醇:(5.0±1.1)、(5.3±1.2)、(5.7±1.4) mmol/L,ln(mALB/24 h):(1.9±0.8)、(2.0±0.6)、(2.6±0.9)](P＜0.0l或P＜0.05).根據尿痠水平的分組併進行Pearson相關分析錶明,尿痠與GFR呈負相關(r=-0.248,P ＜0.01);尿痠與mALB/24 h呈正相關(r=0.254,P ＜0.01);GFR與mALB/24 h呈負相關(r=-0.352,P ＜0.01).Logistic迴歸分析結果錶明,尿痠、年齡、病史、總膽固醇是腎功能不全的危險因素[比值比(OR) =1.013、OR=1.093、OR=1.097、OR=1.369,P ＜0.01或P＜0.05];尿痠、年齡、總膽固醇是異常蛋白尿的危險因素(OR=1.004 、OR=1.029、OR=1.073,均P＜0.05).結論 2型糖尿病患者的腎小毬濾過率及尿mALB排齣量與血尿痠相關,且血尿痠是異常蛋白尿和腎功能不全的危險因素.
목적 탐토2형당뇨병환자혈뇨산수평여신소구려과솔(GFR)、뇨미량백단백(mALB)배출량적관계.방법 장686례2형당뇨병환자안GFR수평분성3조,A조:GFR≥90 ml/(min· 1.73 m2),191례;B조:60 ml/(min· 1.73 m2)≤GFR ＜90 ml/(min· 1.73 m2),383례;C조:GFR ＜60 ml/(min· 1.73 m2),112례;분석불동신공능상태조적림상특정.재장뇨산치종소도대배서,안사분위수분성4조,뇨산＜214.7 μmol/L조,171례;뇨산214.7 ～271.6 μmol/L조,172례;뇨산271.7 ～ 329.4 μmol/L조,172례;뇨산＞ 329.4 μmol/L조,171례;분석불동혈뇨산수평환자적GFR、24 h뇨mALB(mALB/24 h)적변화급상관성.결과 안GFR수평분성적A、B、C조환자적년령、병사、기항、뇨산、총담고순、mALB/24 h적차이균유통계학의의[년령:(53±13)、(61±11)、(68±9)세,병사:(6.0±2.3)、(7.9±3.3)、(14.0±4.5)년,기항:(57±9)、(62±16)、(137±83) μmol/L,뇨산:(258±83)、(282±80)、(345±96) μmol/L,총담고순:(5.0±1.1)、(5.3±1.2)、(5.7±1.4) mmol/L,ln(mALB/24 h):(1.9±0.8)、(2.0±0.6)、(2.6±0.9)](P＜0.0l혹P＜0.05).근거뇨산수평적분조병진행Pearson상관분석표명,뇨산여GFR정부상관(r=-0.248,P ＜0.01);뇨산여mALB/24 h정정상관(r=0.254,P ＜0.01);GFR여mALB/24 h정부상관(r=-0.352,P ＜0.01).Logistic회귀분석결과표명,뇨산、년령、병사、총담고순시신공능불전적위험인소[비치비(OR) =1.013、OR=1.093、OR=1.097、OR=1.369,P ＜0.01혹P＜0.05];뇨산、년령、총담고순시이상단백뇨적위험인소(OR=1.004 、OR=1.029、OR=1.073,균P＜0.05).결론 2형당뇨병환자적신소구려과솔급뇨mALB배출량여혈뇨산상관,차혈뇨산시이상단백뇨화신공능불전적위험인소.
Objective To study the relation among glomerular filtration rate (GFR),urinary albumin execretion and serum uric acid (UA) in patients with type 2 diabetes mellitus.Methods MDRD equation was used to calculate the GFR.A total of 686 patients with type 2 diabetes mellitus were divided into 3 groups according to their GFR.Group A GFR ≥ 90 ml/(min · 1.73 m2),191 cases ; group B:60 ml/(min · 1.73 m2) ≤ GFR ＜90 ml/(min · 1.73 m2),383 cases ; group C:GFR ＜ 60 ml/(min · 1.73 m2),112 cases and clinical features were analyzed.The patients were categorized into four groups based on quartiles of the serum uric acid level to evaluate the diversity and the correlation of GFR and 24h urinary albumin execretion (24h-UAE).UA ＜ 214.7 μmol/L group,171 cases; UA 214.7-271.6 μmol/L geoup,172 cases; UA 271.6-329.4 μmol/L group,172 cases; UA ＞329.4 μmol/L group,171 cases.Results The age,history,creatinine,UA,triglycerides and 24h-UAE were significantly different among group A,B,C segregated by GFR [age:(53 ± 13),(61 ± 11),(68 ± 9)years old,history:(6.0 ±2.3),(7.9 ±3.3),(14.0 ±4.5) years,creatinine:(57 ±9),(62 ± 16),(137 ± 83) μmol/L,UA:(258 ± 83),(282 ± 80),(345 ± 96) μ mol/L,triglycerides:(5.0 ± 1.1),(5.3 ± 1.2),(5.7 ± 1.4) mmol/L,ln (mALB/24 h):(1.9 ± 0.8),(2.0 ± 0.6),(2.6 ± 0.9)] (P ＜ 0.01 or P ＜ 0.05).Pearson correlation showed that serum uric acid was negatively correlated with GFR (r =-0.248,P ＜0.01) ; serum uric acid was positively correlated with 24h-UAE (r =0.254,P ＜ 0.01) ;GFR was negatively correlated with 24h-UAE (r =-0.352,P ＜0.01).Logistic regression analysis suggested that UA,age,history triglycerides were the independent risk factors for renal insufficiency(OR =1.013,OR =1.093,OR =1.097,OR =1.369,P ＜0.01 or P ＜0.05) ;UA,age,history and triglycerides were the independent risk factors for abnormal albuminuria (OR =1.004,OR =1.029,OR =1.073,all P ＜ 0.05).Conclusions There is an association among glomerular filtration rate,urinary albumin execretion and serum UA in patients with type 2 diabetes mellitus.Serum UA level is one of the independent risk factors for abnormal albuminuria and renal insufficiency.
