2型糖尿病患者晨尿微量白蛋白/肌酐与24h尿微量白蛋白相关性分析

目的:研究2型糖尿病(T2DM)患者晨尿微量白蛋白(MALB)/肌酐(Cr)影响因素及用晨尿MALB/Cr评估尿蛋白排泄的可行性。方法:收集179例T2DM患者晨尿和24h尿,测定晨尿MALB、Cr、24h尿MALB及其他各项生化指标,并按肌酐清除率(Ccr)分为25.66~49mL/min、50~79mL/min、≥80mL/min3组,进行各项生化指标与晨尿MALB/Cr的相关性分析。结果:晨尿MALB/Cr与年龄、体质指数(BMI)、DM病程、24h尿MALB、24h尿蛋白(24h尿TP)、收缩压(SBP)、舒张压(DBP)、糖尿病视网膜病变(DR)呈正相关。DM病程、SBP、DR是T2DM患者晨尿MALB/Cr的影响因素。Ccr≥25.66mL/min时,各组晨尿MALB/Cr与24h尿MALB呈正相关。结论:晨尿MALB/Cr可代替24h尿MALB,用于观察尿蛋白排泄情况并对2型糖尿病肾病进行检测和评估,此测定适用于尿量Ccr≥25.66mL/min的不同Ccr的T2DM患者。

Correlation Analysis of Morning Microalbuminuria/Urine Creatinine and 24-h Microalbuminuria in Patients with Type 2 Diabetes Mellitus

Objective: To investigate the influential factors of the first morning microalbuminuria (MALB) / urine creatinine (Cr), and explore the feasibility of replacing 24 h MALB monitoring by measuring morning MALB/ Cr in patients with type 2 diabetes mellitus (T2DM). Methods: Samples of morning urine and 24 h urine were obtained from 179 patients with T2DM. The levels of morning urine MALB, Cr, 24-h MALB and other biochemical indicators were measured. Patients were divided into three groups according to the Cr clearance rate (Ccr) of 25.66-49 mL/min,50-79 mL/min and ≥80 mL/min. The correlation between biochemical indicators and MALB/Cr in morning urine was analyzed. Results: The value of MALB/Cr was positively correlated with age, body mass index(BMI), 24-h MALB, 24-h urine protein, systolic blood pressure (SBP), diastolic blood pressure (DBP) and diabetic retinopathy (DR). The duration of diabetes, SBP and DR were the independent risk factors of MALB/Cr in morning urine of T2DM patients. There was a positive correlation between morning MALB/Cr and 24-h MALB, when Ccr≥25.66 mL/min. Conclusion: Detection of MALB/Cr in morning urine can replace 24-h MALB to evaluate diabetic nephropathy in T2DM patients, which can be applied in T2DM patients with Ccr≥25.66 mL/min.