绝经后2型糖尿病合并肾病患者血清脂蛋白(α)水平变化及意义

目的:探讨绝经后糖尿病肾病患者血清脂蛋白(α)[Lp(α)]水平与尿白蛋白排泄率的关系。方法:选择绝经后2型糖尿病患者68例,根据尿白蛋白排泄率(UAER)分为3组:A组23例为非糖尿病肾病组,UAER<20μg/m in,B组25例为糖尿病肾病微量白蛋白尿组,UAER<20~200μg/m in,C组20例为糖尿病肾病大量白蛋白尿组,UAER>200μg/m in。所有入选病例检测Lp(α)及血脂等。结果:①糖尿病肾病组与非肾病组比较血Lp(α)水平增高(P<0.05),大量白蛋白尿组血Lp(α)水平高于微量白蛋白尿组(P<0.05)。②血Lp(α)水平与病程和血肌酐呈正相关(r=0.802、P<0.01,r=0.825、P<0.01)。结论:绝经后糖尿病肾病者血Lp(α)水平增高,而且与肾功能损害程度正相关;血Lp(α)既是造成肾损害的原因,亦可能继发于肾脏损害,进而加重肾损害。

Serum lipoprotein(α)level and its significance in elderly patients with diabetic nephropathy

Objective:To investigate the relationship between serum Lp(α) level and urinary albumin excretion rate(UAER) in postmenopausal women with type-2 diabetes complicated by diabetic nephropathy(DN).Methods:68 cases with type 2 diabetes mellitus were divided into 3 groups: 23 cases without DN(UARE<20 μg/min),25 cases with microalbuminuria(UAER<20~200 μg/min) and 20 cases with microalbuminuria(UAER>200 μg/min).Serum Lp(α) concentration was measured in all cases.Results:①In patients with DN,serum Lp(α) level increased as compared with T2DM patients without DN(P<0.05).Serum Lp(α) was higher in DN patients with microalbuminuria as compared with DN patients with microalbuminuria(P<0.05).②There was a positive correlation between serum Lp(α) concentration and UAER in DN patients(r=0.802,P<0.01).Conclusion:Serum Lp(α) levels increase in postmenopausal women with T2DM complicated by DN patients and is negatively correlatively with renal impairment.