2型糖尿病患者血清镁离子水平与24h尿微量白蛋白的关系研究

目的探讨2型糖尿病患者血清镁离子水平与24 h尿微量白蛋白的关系。方法选取1 167例2型糖尿病患者,排除明显可能影响血镁水平相关情况后入选510例患者,其中男319例,女191例,年龄18～64岁,接受血电解质、糖脂代谢、肾功能及3次24 h尿微量白蛋白等检查。结果 (1)男性糖尿病非肾病组的血清镁离子水平显著高于糖尿病肾病Ⅲ期和Ⅳ期组,差异有统计学意义[(0.89±0.07)mmol/L vs.(0.86±0.08)mmol/L、(0.82±0.06)mmol/L,P<0.01];而女性中虽然差异无统计学意义,但可见到相同趋势。(2)将男、女人群的血镁值分为4分位数,男性血镁水平位于25%位点者的24 h尿微量白蛋白水平高于血镁位于50%～75%位点者和75%位点者,差异有统计学意义[13.26(5.84～90.84)mg/24 h vs.8.48(4.85～19.50)mg/24 h和7.25(5.48～12.44)mg/24 h,P<0.05];糖化血红蛋白水平高于血镁位于50%～75%位点者和75%位点者,差异有统计学意义[(9.8±2.5)%vs.(8.9±2.3)%和(8.4±2.2)%,P<0.05]。女性位于血镁25%位点者的糖化血红蛋白高于其他组,各组24 h尿微量白蛋白间未见明显差异。(3)相关分析显示,男性的血镁水平分别与24 h尿微量白蛋白(相关系数为-0.177,P<0.01)和糖化血红蛋白(相关系数为-0.201,P<0.01)相关;女性的血镁水平与糖化血红蛋白相关,而与24 h尿微量白蛋白无相关关系。(4)Logistic回归分析显示,收缩压(β=0.073,P=0.000)和血镁水平(β=-8.699,P=0.027)为影响男性尿微量白蛋白的主要因素;收缩压、三酰甘油、空腹血糖等为影响女性尿微量白蛋白的主要因素。结论血镁水平较低的男性2型糖尿病患者,24 h尿微量白蛋白水平较高。血镁水平可能作为男性尿微量白蛋白的标志。

Association between Serum Magnesium Level and 24-hour Urinary Albumin Level in Patients with Type 2 Diabetes Mellitus

Objective To investigate the association between serum magnesium level and 24-hour urinary albumin level in patients with type 2 diabetes mellitus(T2DM). Methods Altogether 1 167 T2DM patients were admitted into our hospital between January 2009 and September 2011.Among them 510 eligible patients entered the final analysis.These 510 patients(319 men and 191 women;aged 18～64 years) underwent tests of blood electrolyte,glucose and lipid metabolism,renal function,and 24-hour urinary albumin(3 times). Results The mean serum magnesium level of male non-nephropathy group was significantly higher than that of male stage 3 and stage 4 nephropathy groups(P<0.01).Similar trend was observed in female groups,although without statistical significance.Quartiles of serum magnesium levels in both male and female groups were computed.The levels of 24-hour urinary albumin and HbA1C of men at the first quartile(Q1) were significantly higher than that of men between the second quartile(Q2) and the third quartile(Q3) and at Q3(P<0.05).HbA1C of women at Q1 was higher than that of other women.However,24-hour urinary albumin level showed no significant difference among male and female groups,respectively.The serum magnesium level was correlated with 24-hour urinary albumin level(r=-0.177,P<0.01) and HbA1C level(r=-0.201,P<0.01) in men.However,in women,the serum magnesium level was only correlated with HbA1C level but not with urinary albumin level.Logistic regression analyses showed that the main factors affecting urinary albumin level were systolic blood pressure(β=0.073,P=0.000) and serum magnesium level(β=-8.699,P=0.027)in men and systolic blood pressure,triglycerides and fasting plasma glucose in women. Conclusion The male T2DM patients with lower serum magnesium level have higher 24-hour urinary albumin level.Serum magnesium level may be an indicator for 24-hour urinary albumin level in male T2DM patients.