2型糖尿病中血糖达标对肾小管重吸收功能的影响

目的:调查分析2型糖尿病（T2DM）患者中血糖达标对肾小管重吸收功能的影响。方法:收集149例住院T2DM患者和50例正常对照者的血液和尿液，测定糖化血红蛋白（HbA1c）、尿α1微球蛋白（α1-MG）、尿肌酐浓度，计算尿α1-微球蛋白尿肌酐比值(α1/CR)。根据HbA1c水平将糖尿病患者分为血糖达标（HbA1c <7%）和不达标（HbA1c ≥7%）两组，分析两组间肾小管重吸收功能指标之间的差异。结果:2型糖尿病组的尿α1/CR水平显著高于对照组（P＜0.001），其中血糖达标和不达标两组间的尿α1-MG （P =0.309）和 α1/CR（P =0.838）不存在显著性差异。结论:在2型糖尿病患者中广泛存在肾小管重吸收功能损伤，控制血糖达标能否改善肾小管重吸收功能尚不明确，有待进一步研究。

Effect of blood glucose level on renal tubular reabsorption function in type 2 diabetes mellitus patients

Objective: To investigate the effect of blood glucose level on renal tubular reabsorption function in patients with type 2 diabetes(T2DM). Methods: A total of 149 hospital patients with T2DM and 50 normal controls were enrolled and the blood and urine samples were collected. The levels of glycosylated hemoglobin (HbA1c), urinary α1-microglobulin (α1-MG), urinary creatinine were dectected, and the urine α1-microglobulin urine creatinine ratio (α1/CR) were calculated. Patients were divided into two groups according to the HbA1c levels: HbA1c <7% as standard group based on glycemic control standard and HbA1c ≥ 7% as the other group. The differences in renal tubular reabsorption function index between the two groups were statistically analyzed. Results: The level of urine α1/CR in T2DM group was significantly higher than that in control group (P ＜0.001), and there was no significant difference in the levels of urinary α1-MG (P =0.309) and α1/CR(P =0.838) between the two groups. Conclusion: Renal tubular reabsorption injury is common in type 2 diabetes mellitus. Now it remains unclear whether glycemic control improves renal tubular reabsorption function, and further studies are needed.