糖化血清白蛋白与糖尿病肾病相关性研究

目的探讨2型糖尿病患者糖化血清白蛋白（glycatedalbumin，GA）与糖尿病肾病的相关性。方法482例2型糖尿病患者根据尿白蛋白水平分为正常白蛋白尿组（正常组）94例，微量白蛋白尿组（微量组）171例及大量白蛋白尿组（大量组）217例，检测3组血压、三酰甘油、胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、血糖、GA，并与同期50例健康体检者（对照组）进行比较。结果大量组舒张压、三酰甘油、胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、GA、血糖均高于正常组（P〈0．05）。大量组、微量组和正常组GA分别为（33．O±9．3）％、（18．9±3．1）％、（14．1±2．2）％，均高于对照组（（1．89±1．50）％）（F=311．511，P〈0．01）；糖尿病肾病的严重程度与GA水平呈正相关（r=0．885，P〈0．01）。logistic回归分析显示，GA是影响糖尿病。爵病发病及病情严重程度的危险因素，多因素调整后OR=2．97，95％CI：2．228～3．959。结论GA在糖尿病肾病发病中起重要作用，并与糖尿病肾病的分期密切相关。

Relationship between glycated albumin level and diabetic nephropathy in patients with type 2 diabetes mellitus

Objective To investigate the relationship between glycated albumin （GA） level and diabetic nephropathy in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 482 patients with T2DM were divided into normoalbuminuria （NAU） group （n = 94）, microalbuminuria （MAU） group （n ~ 171） and macroalbuminuria （CAU） group （n=217） according to the different albuminuria levels. The blood pressure, triacylglycerol, total cholesterol, low density lipoprotein-cholesterol, glycosylated hemoglobin, plasma glucose and GA were detected and compared with other 50 healthy volunteers （control group）. Results The diastolic blood pressure, triacylglycerol, total cholesterol, low density lipoprotein-cholesterol, glycosylated hemoglobin, GA and plasma glucose were higher in CAU group than those in NAU group（P〈0.05）. GA levels in CAU, MAU and NAU groups were （33.0±9.3）%, （18.9±3.1）% and （14.1± 2.2） %, significantly higher than GA level in control group （（1.9 ±1.5） %） （F= 311. 511, P〈0.01）. The severity of diabetic nephropathy was correlated with GA level （r=0. 885, P〈0.01）. Logistic regression showed that GA was a risk factor for the development and progression of DN after adjustment for multi-factors （OR= 2.97, 95% CI： 2. 228 to 3. 959）. Conclusions GA plays an important role in the pathogenesis of diabetic nephropathy, and is closely correlated with the phases of diabetic nephropathy.