代谢综合征对2型糖尿病患者糖尿病肾病的影响分析

目的探讨代谢综合征（MS）对2型糖尿病（T2DM）患者糖尿病肾病（DN）发病的影响。方法根据2004年中华医学会糖尿病学分会（CDS）关于MS诊断标准，将1025例住院的T2DM患者分为单项异常组（第1组）、两项异常组（第2组）和MS组（第3组），比较三组间DN患病率；根据白蛋白／肌酐比值诊断DN，比较DN与非DN患者之间血糖、血压、血脂的水平差异，并应用多元回归分析了解MS及其组分与DN之间的相关关系。结果1025例T2DM患者中，DN以及MS的患病率分别为39．0％（400／1025）和38．1％（391／1025）。第1组、第2组和第3组中DN患病率分别为17．9％（33／184）、32．7％（147／450）、56．3％（220／391oDN患者中HbA1c收缩压（SBP）、舒张压（DBP）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、年龄、病程均显著高于非DN患者（p＜0．05或P〈0．01），HDL—C显著低于非DN患者（P＜0．05）多元逐步回归分析显示，病程、SBP、TG、LDL-C、MS是影响T2DM患者中DN独立的危险因素。结论MS是T2DM患者DN独立影响因素。

Analysis of the Influence of Metabolic Syndrome on Diabetic Nephropathy in Type 2 Diabetes

Objective To investigate the relationship between metabolic syndrome （MS） and diabetic nephropathy （DN） in type 2 diabetes mellitus （T2DM）. Methods According to the diagnostic standard of CDS （2004）, 1025 inpatients of T2DM were divided into three groups： single abnormal group （group 1）, two abnormal group （group 2） and MS group （group3）, and DN prevalence was compared among three groups. The individuals were divided into two groups： DN group and non-DN group according to the albumin/ereatinine ratio and the differences of the blood sugar, the blood pressure, the blood fats levels were compared between two groups. Multiple regression analysis was performed on the relation of DN with MS and its components. Results The prevalence of DN and MS in the present study was 39.0%, 38.1%, respectively. In the group 1, group2 and group 3, the prevalence of DN was 17.9%, 32.7%, 56.3%, respectively. In the DN group, the parameters including HbAlc, systolic pressure （SBP）, diastolic pressure （DBP）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-C）, age, the diabetes course were obviously higher than those in the non-DN group （P〈0.05 or P〈0.01）, while the level of high density lipoprotein cholesterol （HDL-C） was lower than that in the non-DN group （P〈0.05）. Multiple regression analysis showed that, the diabetes course, SBP, TG, LDL-C and MS were independent risk factors for DN in T2DM. Conclusion MS is a factor related to DN in patients with T2DM.