CAJ | 학술논문

目的：通过对社区居民进行横断面研究，分析2型糖尿病（T2DM）患者糖代谢指标与尿白蛋白肌酐比的相关性。方法研究对象为参加中华医学会发起的“中国T2DM患者肿瘤发生风险的流行病学研究”大连地区的社区居民，入选研究对象共计10155例。检测空腹血糖（ FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（ HbA1c）、血脂、尿白蛋白及尿肌酐，根据尿白蛋白肌酐比（ UACR）将研究对象分为：正常白蛋白尿组，微量白蛋白尿组及大量白蛋白尿组，分析3组间糖代谢指标的差异，分析上述指标与UACR的相关性。结果（1）不同血糖状态组，其尿白蛋白异常率发生不同，糖尿病组患者其尿白蛋白异常率明显高于非糖尿病组患者，P＜0．05。（2）对于糖尿病患者，微量白蛋白尿及大量白蛋白尿组的FPG、2hPG及HbA1c水平均明显高于正常白蛋白尿组；FPG、2hPG及HbA1c水平更高的糖尿病患者，其微量白蛋白尿及大量白蛋白尿发生率也更高，P＜0．05。（3） Pearson相关分析显示：FPG、2hPG、HbA1c、总胆固醇水平（TC）、甘油三酯水平（TG）、收缩压（SBP）、舒张压（DBP）、年龄、病程、体质指数（BMI）、腰臀比（ WHR）与UACR呈正相关（ r值分别为0．259、0．197、0．239、0．077、0．153、0．219、0．114、0．096、0．087、0．114），高密度脂蛋白胆固醇水平（HDL－C）与UACR呈负相关（r值为－0．071）， P均＜0．05。（4）多元逐步回归显示：FPG、HbA1c、SBP、TG、HDL－C与UACR独立相关。（β值分别为：0．164、0．101、0．200、0．076、－0．069），P均＜0．05。结论 T2DM患者糖代谢指标与UACR密切相关，FPG、HbA1c、SBP、TG、HDL－C为UACR的独立危险因素。
목적：통과대사구거민진행횡단면연구，분석2형당뇨병（T2DM）환자당대사지표여뇨백단백기항비적상관성。방법연구대상위삼가중화의학회발기적“중국T2DM환자종류발생풍험적류행병학연구”대련지구적사구거민，입선연구대상공계10155례。검측공복혈당（ FPG）、찬후2 h혈당（2hPG）、당화혈홍단백（ HbA1c）、혈지、뇨백단백급뇨기항，근거뇨백단백기항비（ UACR）장연구대상분위：정상백단백뇨조，미량백단백뇨조급대량백단백뇨조，분석3조간당대사지표적차이，분석상술지표여UACR적상관성。결과（1）불동혈당상태조，기뇨백단백이상솔발생불동，당뇨병조환자기뇨백단백이상솔명현고우비당뇨병조환자，P＜0．05。（2）대우당뇨병환자，미량백단백뇨급대량백단백뇨조적FPG、2hPG급HbA1c수평균명현고우정상백단백뇨조；FPG、2hPG급HbA1c수평경고적당뇨병환자，기미량백단백뇨급대량백단백뇨발생솔야경고，P＜0．05。（3） Pearson상관분석현시：FPG、2hPG、HbA1c、총담고순수평（TC）、감유삼지수평（TG）、수축압（SBP）、서장압（DBP）、년령、병정、체질지수（BMI）、요둔비（ WHR）여UACR정정상관（ r치분별위0．259、0．197、0．239、0．077、0．153、0．219、0．114、0．096、0．087、0．114），고밀도지단백담고순수평（HDL－C）여UACR정부상관（r치위－0．071）， P균＜0．05。（4）다원축보회귀현시：FPG、HbA1c、SBP、TG、HDL－C여UACR독립상관。（β치분별위：0．164、0．101、0．200、0．076、－0．069），P균＜0．05。결론 T2DM환자당대사지표여UACR밀절상관，FPG、HbA1c、SBP、TG、HDL－C위UACR적독립위험인소。
Objective To evaluate the relationship between glucose metabolism and urinary albumin creatinine ratio in type 2 diabetes.Methods A total of 10 155 subjects in Dalian area were enrolled in the epidemiological study of tumor risk of Chinese type 2 diabetes mellitus patients.Values of glucose metabolism, including the fasting plasma glucose (FPG), 2 hours blood glucose (2hPG), glycosylated hemoglobin (HbA1c), blood lipid, urinary albumin and creatinine, were meas-ured.According to the urine albumin creatinine ratio ( UACR) , subjects were divided into three groups including normoal-buminuria group, microalbuminuria group and macroalbuminuria group.Difference among the three groups in glucose meta-bolic indexes and the relationship between glucose metabolism and UACR were analyzed.Results (1) In different glycemic status group, the incidence of abnormal urinary albumin was different.In diabetic group, it was much higher than that in non-diabetes group (P<0.05).(2) As for diabetes, the levels of FPG, 2hPG and HbA1c in microalbuminuria and macroalbuminuria groups were much higher than those of normoalbuminuria group.As the levels of glucose metabolism were higher, the incidence of microalbuminuria and macroalbuminuria increased.(3) Pearson correlation coefficient analysis re-vealed that FPG, 2hPG, HbA1c, total cholesterol (TC), triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure ( DBP) , age, course of disease, body mass index ( BMI) and waist-hip ratio ( WHR) were positively cor-related with UACR (r=0.259, 0.197, 0.239, 0.077, 0.153, 0.219,0.114, 0.096, 0.087, 0.114 respectively);high density lipoprotein cholesterol (HDL-C) and UACR were negatively correlated (r=-0.071).All P values were less than 0.05.(4)Multiple stepwise regression showed that FPG,HbA1c,SBP,TG,HDL-C were risk factors for the UACRβ=0.164,0.101,0.200,0.076,-0.069), all P values <0.05.Conclusion The indexes of glucose metabolism in T2DM diabetes are closely related to the UACR.FPG,HbA1c,SBP,TG and HDL-C are risk factors for the UACR.