肥胖对2型糖尿病患者心室重构的影响

目的评价肥胖对2型糖尿病(T2DM)患者心室重构的影响。方法将102例T2DM患者分成两组,BMI<25 kg/m2为T2DM组,BMI≥25 kg/m2为肥胖组,分别检测两组的血压、身高、体质量及血糖、血脂水平;并行心脏超声检查,测量舒张期末左室内径(LVD),舒张期末左室后壁厚度(LVPW)、舒张期末室间隔厚度(IVS)以评估左室结构,计算左室质量(LVM)、相对室壁厚度(RWT)和左室质量指数(LVMI)。结果两组比较LVD、IVS、RWT无统计学差异(P均>0.05),肥胖组IVS、LVM和LVMI高于T2DM组(P均<0.05)。多元线性回归分析显示,BMI是LVMI的独立危险因素。结论肥胖与T2DM患者的LVM相关,BMI是糖尿病LVMI的独立危险因素。     

高血压患者心脏重构与早期肾功能损害及脂联素的相关性探讨

目的 探讨老年高血压(EH)患者心脏重构与早期肾功能损害及脂联素的相关性.方法 老年高血压病患者221例、老年正常对照组116名均采静脉血测定血尿素氮(BUN)、血肌酐(Cr)及脂联素(APN),留24 h尿测定尿微量白蛋白,并计算内生肌酐清除率(Ccr).所有患者行心脏超声检测,测量舒张期末左室内径(LV)、舒张期末左室后壁厚度(LVPW)、舒张期末室间隔厚度(IVS),计算左室重量指数(LVMI).结果 EH早期肾功能损害组的IVS、LVPW、LVM、LVMI和脂联素均显著高于肾功能正常组(P<0.05).在30 mL/min≤Ccr<60 mL/min组与Ccr≥90 mL/min组比较,LVPW、LVM、LVMI和脂联素显著增大(P<0.05),而LV和IVS无统计学意义(P>0.05);3组间两两比较,各指标无统计学差异(P>0.05).EH的左室重构组中尿白蛋白的排泄率显著高于无左室重构组(P<0.05),Ccr显著低于无左室重构组(P<0.05),而BUN、Cr无统计学意义(P>0.05).结论 高血压早期肾功能损害对心血管重构有显著影响;肾功能是脂联素的显著调节因素,而低脂联素血症是心血管疾病的预测因素.     

高龄老年患者动脉及心脏结构与功能变化

目的评价高龄老年患者动脉及心脏结构、功能变化。方法老年高血压或糖尿病患者分为两组,高龄组：80岁及以上,119例;老年组：60—79岁,78例。分别检测颈动脉内膜中层厚度（IMT）、冠状动脉钙化积分（CS）、动脉脉压（PP）;心脏超声检测室间隔厚度（IVS）、左室室壁厚度（LVPW）、舒张末期左心室内径（LVDd）、收缩末期左心室内径（LVDs）、收缩末期左心房前后径（LAD）、左室质量（LVM）、左室质量指数（LVMI）、左室射血分数（EF）、左心室舒张早期二尖瓣最大血流速度E峰及舒张晚期二尖瓣最大血流速度A峰比值（E／A）。结果高龄组冠脉钙化总积分（TCS）、右冠脉钙化积分（CSRCA）、IMT、PP、LVPW较老年组增高（P〈0．01）,E／A较老年组下降（P〈0．05）。结论老年期随增龄颈动脉内膜增生及左室肥厚进一步加重;高龄老人心脏舒张功能明湿下降,但对收缩功能影响不大;增龄导致的冠状动脉钙化更易侵犯右冠脉。     

血尿酸水平对老年2型糖尿病患者心脏结构与功能的影响

目的探讨血尿酸水平对老年2型糖尿病（T2DM）患者心脏结构及功能的影响。方法选择98例无心脏病病史的老年T2DM患者,根据血尿酸水平分为正常尿酸（A组）、高尿酸血症（B组）两组;均行彩超检测室间隔舒张末厚度（IVST）、左室后壁舒张末厚度（LVPWT）、左室舒张末内径（LVDd）、左室收缩末内径（LVDs）、左房内径（LAD）、左室射血分数（LVEF）、左室短轴缩短率（FS）、二尖瓣E峰及A峰血流速度,计算E/A比值、左室质量（LVM）及左室质量指数（LVMI）。结果与A组比较,B组LAD、LVDs、LVDd明显增大,IVST、LVPWT、LVM、LVMI明显增加,E/A比值变小,EF、FS明显降低（P〈0.01或〈0.05）。结论老年T2DM并高尿酸血症患者的心脏结构改变明显,左室收缩、舒张功能异常严重。     

老年男性高血压合并2型糖尿病对左室结构和舒张功能的影响

目的探讨老年男性高血压患者2型糖尿病对心脏结构和功能的影响及临床意义。方法选择老年男性高血压患者共70例，分为高血压伴糖尿病组及单纯高血压组。采用超声多普勒结合组织多普勒显像（TDI）测定左室结构、左室心肌质量（INM）、左室质量指数（LVMI）、左室舒张功能及左室舒张末压，计算二尖瓣舒张早期最大血流速度（E）与二尖瓣瓣环-侧壁交界处舒张早期速度峰值（Em）的比值（E／Em）。结果①高血压伴糖尿病组患者室间隔（IVS）、左室后壁的厚度（LVPWT）和LVM明显大于单纯高血压组（P〈0．05）。左室内径（LVDd）和LVMI有升高倾向，但无明显差异（P〉0．05）。②高血压伴糖尿病组Em降低，E／Em升高（P〈0．05）。而EF、FS及E峰、A峰、E／A无显著差异（P〉0．05）。③单纯高血压组LVMI与E／Em呈正相关（r=0．336，P〈0．05）。高血压伴糖尿病组LVMI与E／Em、E呈正相关（r=0．74、0．456，P均〈0．05），与Em、Am呈负相关（r=-0．516、-0．42，P均〈0．05）。结论在老年男性高血压患者中2型糖尿病与室壁增厚、LVM增加、左室松弛性受损以及左室舒张末压升高有关，这些对心脏结构和左室舒张功能的有害作用有助于糖尿病患者心血管事件的发生。     

CysC水平与T2DM患者心室重构及预后关系探讨

目的探讨血清胱抑素C(CysC)水平与2型糖尿病(T2DM)患者心室重构及预后关系。方法选择2013年1月~2016年6月于四川省科学城医院心内科就诊的T2DM患者106例作为研究组,选择同期在我院体检的健康者90例作为对照组,检测两组纳入者CysC水平、体质指数(BMI)、血压。根据研究组患者CysC水平将其分为升高组(CysC1.09 mg/L)和正常组(CysC≤1.09 mg/L),采用全自动血液生化分析仪检测研究组患者的空腹血糖(FPG)、三酰甘油(TG)、肌酐(SCr)、尿素氮(BUN)、高密度脂蛋白(HDL-C)、胰岛素抵抗水平(HOMA-IR)、糖化血红蛋白(HbA1C);超声心动图检查:测量患者左心室后壁厚度(LVPW)、左心室舒张末期内径(LVDD)、室间隔厚度(IVS),计算左心室质量(LVM)、左心室质量指数(LVMI),并对患者6个月内发生心血管不良事件进行随访。结果研究组患者的高CysC检出率显著较对照组高,差异有统计学意义(P0.05),CysC升高组和CysC正常组一般资料比较差异无统计学意义(P0.05),CysC升高组的LVPW、LVM、LVMI显著高于CysC正常组,差异均有统计学意义(P0.05),CysC升高组出现1例心力衰竭、3例心律失常、1例心肌梗死、3例心绞痛、1例死亡,心血管不良事件发生率显著高于对照组,差异有统计学意义(P0.05),Pearson相关性分析结果显示,CysC水平与LVPW、LVM、LVMI、心血管不良事件呈正相关,与LVD、IVS无相关性。结论 CysC水平与T2DM患者心室重构和心血管不良事件具有正相关,CysC水平较高导致患者心室重构,且患者易发生心血管不良事件,预后较差。     

代谢综合征与左心室肥厚关系的分析

目的:探讨代谢综合征(MS)与左心室肥厚(LVH)的关系。方法:在体检人群中选择598例,其中男性392例,女性206例,年龄40～80岁,平均(56.9±14)岁。根据1999年WHO高血压诊断标准及2004年中华医学会糖尿病分会MS诊断标准,将其分为正常人组100例,单纯高血压病组(EH)100例,血压正常的代谢综合征组(NMS)108例,高血压代谢综合征组(HMS)290例。用彩色多普勒超声诊断仪,利用二维超声心动图检测室间隔厚度、左心室后壁厚度、左心室舒张末期内径,计算出左心室心肌重量指数(LVMI,g/m2)。结果:NMS组的舒张末期室间隔厚度(IVS)、舒张末期左心室后壁厚度(LVPW)、左心室重量(LVM)、左心室重量指数(LVMI)、LVH大于正常人组(P<0.05)。HMS组的IVS、LVPW、LVM、LVMI及LVH显著大于EH组(P<0.01);HMS组的IVS、LVMI、LVH显著大于NMS组(P<0.01),LVPW、LVM大于NMS组(P<0.05)。结论:高血压患者如合并糖尿病或肥胖或血脂紊乱,则随着代谢性危险因素的增加,LVH则更明显。对有高血压的MS则应控制血压,同时降糖、降脂和减轻体重,以防止多种危险因素聚集而导致的LVH。     

臂踝脉搏波传导速度与冠心病患者心肌重构及心功能关系

脉搏波传导速度(PWV)是近年来用于动脉硬化检测的一种很好无创方法,2007年欧洲高血压学会(ESH)/欧洲心脏病学会(ESC)高血压指南已将其列为动脉血管功能评价的一个新指标[1].PWV对冠心病的发生发展有危险预测作用[2,3],但其与冠心病患者心肌重构及心功能的关系尚不清楚,本文就其相关因素进行临床观察分析. 1对象与方法 1.1 对象依照1979年WHO颁布的缺血性心脏病诊断标准,按住院顺序随机选取98例冠心病患者,根据臂踝PWV(baPWV)的大小分为baPWV正常组40例,baPWV增高组58例.每例均抽血行脑钠肽(BNP)检查,及多普勒超声心动图测量左室质量指数(LVMI)、左室舒张末内径(LDVd)与左室射血分数(LVEF).所有患者均排除高血压、脑卒中及糖尿病,两组患者性别、年龄无统计学差异(P＞0.05),具可比性.1.2方法baPWV测量:采用日本科林公司生产的VPI000动脉硬化自动测量仪,baPWV≥1 400 cm/s定义为增高[4].BNP检测:采用竞争性放射免疫分析法(试剂盒购自美国Phoenix药物有限公司).LVMI与LVEF的检测:应用美国Agilent 公司生产的Sonos5500彩色超声仪,测出LVDd、舒张末期室间隔厚度(IVS)和舒张末期左室后壁厚度(LVPW),根据De-vereux和Reichek方程得出左心室质量(LVM) (g)=1.04(LVD d+IVS+ LVPW)3-(LVD d)3]-13.6,再按身高、体重计算体表面积,最后得到LVMI (g)=LVM/体表面积.     

原发性高血压患者微量白蛋白尿与心脏结构改变的关系

该文研究原发性高血压患者中微量白蛋白尿组及非微量白蛋白尿组在临床特征及心脏结构诸指标方面的差异并探讨其临床意义。以60例原发性高血压患者为研究对象，停服抗高血压药物2周后，检测其晨尿白蛋白浓度（Alb）及肌酐（Cr）水平，并以彩色多普勒超声心动图检测其室间隔厚度（IVS）、左室后壁厚度（PWT）、左室舒张末期内径（LVDd），计算左室重量（LVM）及左室重量指数（LVMI）。     

血浆一氧化氮和血管紧张素Ⅱ在原发性高血压及左室肥厚中的作用

目的探讨血浆一氧化氮（NO）和血管紧张素Ⅱ（AngⅡ）在原发性高血压（EH）患者中的变化,以及与左室肥厚（LVH）的相关性。方法分别选取EH伴LVH患者、EH不伴LVH患者及正常人各30例,检测血浆NO、AngⅡ水平及左室重量（LVM）,进行组间比较及相关分析。结果（1）EH伴LVH组血NO水平低于EH不伴LVH组、正常对照组俨〈0．01）,EH不伴LVH组NO水平低于正常对照组（P〈0．01）;（2）三组之间血AngⅡ水平与室间隔舒张末期厚度（IVS）、左室后壁舒张末期厚度（LVPW）、LVM呈正相关（P〈0．01或0．05）;（3）血压、LVM与NO呈负相关、与AngⅡ、LVM呈正相关（P〈0．01或0．05）。结论研究结果提示：血浆NO、AngⅡ参与了EH及LVH形成的病理生理过程。     

Relationship between Apolipoprotein E polymorphism and nephropathy in type-2 diabetic patients

Twenty to forty percent of type-2 diabetic patients (DM2) present nephropathy. Genetic polymorphism of Apolipoprotein E (Apo E) has been proposed as a risk factor in the development and progression of diabetic nephropathy. The purpose of the study was to evaluate the relationship between Apo E polymorphism and presence of nephropathy in DM2 patients. We studied 85 DM2 patients with a similar nutritional state, environmental and socioeconomic condition and more than 10 years of evolution. They were grouped in DM2 patients with kidney complications (n=56) and without kidney complications (n=29; control group). Apo E genotype was determined by restriction fragment-length polymorphism analysis. A plasmatic biochemical characterization was performed on all the subjects studied. The 85 DM2 patients had arterial hypertension in treatment. The nephropathy diabetic group showed differences (p<0.001) in BMI, systolic blood pressure, glycemia, cholesterol (total, HDL and LDL), HbA1c and creatinine. The e4 allelic frequency was 8% in the nephropathy group versus 25.9% in the control group. Apo e3 allele and E3/3 genotype frequency were higher and E3/4 genotype was lower in the nephropathy group than in controls. These groups also showed differences in total, HDL and LDL cholesterol. DM2 patients without nephropathy presented a higher frequency of e4 allele. These results could suggest a protective role of e4 allele in the development and progression of diabetic nephropathy.     

Hearing impairment in type 2 diabetics and patients with early diabetic nephropathy

Aims

The study was to investigate the hearing function in subjects with non-diabetic nephropathy and diabetic nephropathy and analyze related clinical indexes of hearing impairment.

The effect of diabetes mellitus and end-stage renal disease on the number of CD34+ cells in the blood

The aim of this study was to investigate the effect of end-stage renal disease (ESRD) and diabetes mellitus (DM) on the number of stem cells in the peripheral blood. Sixty-two patients diagnosed with ESRD who had not received dialysis previously, 25 patients with a diagnosis of DM without nephropathy, and 21 healthy volunteers were included in the study. The group diagnosed with ESRD was divided into two groups. The first group (DM-CRD) consisted of 28 patients with DM who had developed chronic renal disease (CRD). The second group (NON-DM-CRD) consisted of 34 patients without DM who had CRD by etiology. The routine complete blood count, renal function, and number of CD34+ cells were determined for all of those involved in the study. The microalbumin/creatinine levels were measured, and glomerular filtration rates were calculated in all patients. The number of CD34+ cells was found to be significantly lower in the DM control group and DM-CRD group compared with the healthy group. No statistically significant difference was found between the NON-DM-CRD and the healthy control group. There was a moderate negative correlation between the ratio of microalbumin/creatinine and the number of CD34+ cells. A significant reduction in the number of CD34+ cells was shown in subjects with DM and ESRD caused by diabetic nephropathy.     

HCY水平对于2型糖尿病早期肾病的独立预测意义

目的研究血清同型半胱氨酸（HCY）水平与2型糖尿病（T2DM）早期肾病的关系。方法将收集到的112例T2DM患者作为观察组,按尿微量白蛋白含量分为三组：正常白蛋白组、早期肾病组和临床蛋白尿组,对HCY水平分别进行检测,与正常对照组进行分析比较。结果 T2DM早期肾病中HCY水平显著高于对照组,差异有统计学意义（P〈0.05）;T2DM各亚型HCY水平与对照组差异有统计学意义（P〈0.05）;且HCY的变化与尿微量白蛋白有一定相关性。结论血清HCY水平的变化与T2DM早期肾病密切相关,可作为T2DM早期肾病的预测因素,检测T2DM患者HCY水平有利于判断及诊断糖尿病早期肾病的发生。     

肾上腺髓质素与糖尿病肾病肾小管间质病变的关系研究

目的研究肾上腺髓质素(ADM)水平的变化对糖尿病肾病(DN)肾小管间质病变的关系。方法将42例糖尿病患者分为单纯糖尿病组(A组)、早期糖尿病肾病(DN)组(B组)、临床期DN组(C组),另选11例健康志愿者为D组。检测其ADM、内皮素-1(ET-1)水平,分析其与肾小管间质损伤标志物尿α1-MG、β1-MG水平的相关性。结果 4组研究对象血浆ADM及ET-1水平比较,差异均有统计学意义(P<0.05);血浆ADM与肾小管间质损伤标志物血、尿α1-MG,尿β1-MG水平呈正相关(均P<0.05)。结论 DN早期的肾脏血流动力学紊乱,ADM在肾小管间质病变的发展中可能起着重要的作用。     

中性粒细胞与淋巴细胞比值与2型糖尿病肾病进展的相关性

目的探讨中性粒细胞与淋巴细胞比值与2型糖尿病肾病进展的相关性。方法2014年9月—2016年12月间采用回顾性队列研究纳入2型糖尿病患者492例,据24 h尿蛋白总量将492例2型糖尿病患者分为糖尿病无肾病组(DM组)424例,糖尿病肾病组(DN组)68例。收集其临床资料,追踪其3年后DN进展情况。将基线中性粒细胞与淋巴细胞比值(NLR)水平按四分位法分为四组,即最低四分位数组(I组)≤1.37、第二四分位数组(II组)1.38~1.83、第三四分位数组(III组)1.84~2.21、最高4分位数组(IV组)≥2.22。按DN是否进展,将研究对象分为进展组(A组)和未进展组(B组),比较两组基线资料,采用二元Logistic回归,评估糖尿病病程、SBP、HbA1c、BMI及基线NLR水平与DN进展之间的相关性。结果3年后,64例(13.00%)患者糖尿病肾病进展,其中新发糖尿病肾病42例(8.53%)。单因素分析中,A组与B组相比较,年龄、病程、BMI、收缩压、NLR、FPG、HbA1c、TC、TG差异有统计学意义(P<0.05)。结论NLR水平>1.83是T2DM患者DN进展的独立危险因素。     

Increased leptin concentrations and lack of gender difference in Type 2 diabetic patients with nephropathy

Leptin plays an important role in the regulation of body weight and energy balance. Women have higher circulating leptin level than men. In this study, we examined serum leptin concentrations in Type 2 diabetic men and women with or without nephropathy. Fasting plasma glucose (FPG), lipid profile, and serum leptin concentrations were measured in 34 Type 2 diabetic patients with nephropathy (DMN), 12 normoalbuminuric Type 2 diabetic subjects (DM) and 34 non-diabetic control subjects, all matched for age and body mass index (BMI). RESULT: Patients with diabetic nephropathy had lower high-density lipoprotein cholesterol and higher triglyceride, FPG, urinary albumin/creatinine ratio (ACR) and serum creatinine than the other two groups. There was a significant trend in serum leptin concentrations (P<0.001, analysis of variance ANOVA) across the three groups with the main difference being detected between DMN and control subjects (DMN: 17.5 +/- 16.8 ng/ml, DM: 14.6 +/- 10.5 ng/ml and control: 9.1 +/- 7.1 ng/ml). Women had higher serum leptin concentration than men in the control group (12.5 +/- 7.3 ng/ml versus 4.2 +/- 2.0 ng/ml, P=0.001) and in the DM group (18.9 +/- 11 ng/ml versus 8.6 +/- 5.9 ng/ml, P=0.07) whereas this gender difference was not observed in the DMN group (18.6 +/- 17.0 ng/ml versus 16.8 +/- 17.0 ng/ml, P=0.754). On multivariate analysis, ACR (=0.411, P<0.001) and BMI (=0.240, P=0.002) were independently associated with serum leptin concentrations (R2=0.194, F=22.1, P<0.001) in the whole group. In the DMN group, ACR (=0.370, P=0.016) was the only independent determinant of serum leptin concentrations (R2=0.159, F=11.4, P=0.016). Serum leptin concentrations were higher in Type 2 diabetic patients with nephropathy than normoalbuminuric diabetic patients and controls. Diabetic men with nephropathy had proportionally higher serum leptin such that the gender difference in leptin observed in non-nephropathic individuals was abolished.     

Dobutamine stress echocardiography: false positive scans in proteinuric patients with Type 1 diabetes mellitus at high risk of ischaemic heart disease

Patients with Type 1 diabetes mellitus have an increased risk of ischaemic heart disease (IHD). When diabetes is complicated by nephropathy this risk is further increased and asymptomatic IHD is common. New techniques for non-invasive cardiac evaluation are now available and one of these, Dobutamine Stress Echocardiography (DSE), was studied in subjects with Type 1 DM and nephropathy who had no evidence of IHD. DSE was performed on 18 subjects (13 male, 5 female; mean age 37.8 ± 3.4 years), diabetes duration 23.7 ± 1.2 years and nephropathy diagnosed for 10.9 ± 1.3 years. There were 7 (38 %) positive scans—suggesting asymptomatic IHD; 16.7 % of subjects studied had a significant arrhythmia. Coronary angiography was performed in 6 of the 7 subjects with positive DSEs and was positive in only 2. These results suggest that DSE has a high rate of false positive results in Type 1 DM patients suffering from nephropathy and may limit its usefulness in these subjects. © 1998 John Wiley & Sons, Ltd.     

Glycosaminoglycans urinary excretion as a marker of the early stages of diabetic nephropathy and the disease progression

BACKGROUND: Diabetes mellitus affects the metabolism of several components of extra-cellular matrix, including glycosaminoglycans (GAG). Alterations in the metabolism of GAG may play an important role in the development of diabetic complications. METHODS: Consequently, the relationship between diabetic nephropathy and urinary GAG excretion has been estimated in 86 diabetic patients (33 type 1 diabetes mellitus (DM), 53 type 2 DM) in comparison to 30 healthy controls (Figure 1). GAG concentration in 24-h urine samples has been determined by precipitation with cetylpyridinum chloride and potassium acetate in ethanol followed by a fluorometric test with 2-Hexadecyl-9H-pyrido(4,3b)indolium Bromide. RESULTS: Diabetic subjects excrete significantly more GAG than the control group (66.47 mg/24 h vs 50.11 mg/24 h). A marked difference in urinary GAG excretion between diabetic patients with nephropathy (74.66 +/- 7.5 mg/24 h) and without nephropathy (50.13 +/- 5.37 mg/24 h) has been detected. With diabetic nephropathy, patients with a longer history of GAG excretion experience an increase. An increased urinary GAG excretion has been detected in patients with microalbuminuria or macroalbuminuria. CONCLUSIONS: In conclusion, it can be stated that all patients with DM compared to the control group show an increase in GAG excretion independent of diabetes duration. Urinary GAG excretion positively correlates with the duration of diabetic nephropathy. The assessment of GAG excretion values may be useful for determining the early stages of diabetic nephropathy and the progression of the disease.     

糖尿病肾病相关危险因素分析（英文）

目的：探讨影响糖尿病肾病的相关危险因素。方法：入选明确诊断2型糖尿病患者238例,根据尿微量白蛋白/尿肌酐的比值（UACR）分为糖尿病无肾病组（糖尿病1组,90例）,早期糖尿病肾病组（糖尿病2组,73例）,临床糖尿病肾病组（糖尿病3组,75例）,收集所有患者的临床资料,并检测餐前及餐后2h血糖（FBG、2hPB）,血脂、尿酸（UA）、纤维蛋白原（Fg）、糖化血红蛋白（HbA1c）等生化指标,并分析其与糖尿病肾病的相关性。结果：糖尿病1组、糖尿病2组、糖尿病3组的糖尿病病程[（7.25±6.29）年比（10.25±7.67）年比（13.53±7.82）年]、FBG[（8.46±2.52）mmol/L比（9.52±3.38）mmol/L比（10.82±3.30）mmol/L]、2hPB[（18.40±5.64）mmol/L比（20.27±5.94）mmol/L比（22.59±6.14）mmol/L]、HbA1c[（7.96±1.65）%比（8.60±1.76）%比（9.55±2.09）%]、甘油三酯[（1.72±0.86）mmol/L比（2.34±1.87）mmol/L比（3.16±1.85）mmol/L]、Fg[（3.49±0.93）g/L比（3.88±1.21）g/L比（4.99±2.10）g/L]、UA[（295.42±52.34）μmol/L比（324.18±96.29）μmol/L比（351.23±56.88）μmol/L]水平逐渐显著升高（P〈0.05～〈0.01）。Lo-gistic逐步回归分析显示,糖尿病病程、HbA1c、TG、Fg、UA是糖尿病肾病的危险因素（优势比=1.008～1.910,P〈0.01～〈0.001）。结论：糖尿病病程、血糖、血脂、血尿酸和纤维蛋白原是糖尿病肾病的危险因素;尿微量白蛋白/尿肌酐比值升高反映糖尿病人病情的进展,测定它有助于糖尿病的防治。