2型糖尿病患者肥胖不同指标与尿微量白蛋白关系的探讨

目的:探讨2型糖尿病(T2DM)患者尿微量白蛋白(UMA)的发生与腰臀比(WHR)、腰围身高比(WHtR)及体质量指数(BMI)等之间的关系.方法:292例T2DM患者根据BMI分为正常组(88例)、超重组(121例)和肥胖组(83例),分析各组24 h UMA变化及其影响因素.结果:随着BMI的增加,WHR、WHtR、24 h UMA、舒张压(DBP)呈上升趋势,差异有统计学意义(P＜ 0.05或P＜0.01)；UMA与病程、WHtR、WHR、BMI、SBP、DBP呈显著正相关(r分别为0.119、0.603、0.426、0.509、0.210和0.205,P＜0.05或P＜0.01)；多元逐步回归分析结果表明WHtR、SBP是UMA的危险因素(P＜ 0.05或P＜0.01).结论:WHtR较大的T2DM患者微量白蛋白尿发生的可能性较大,腹型肥胖是微量白蛋白尿的危险因素.

The Relationship between Microalbuminuria and Different Obesity Indicators in Patients with Type 2 Diabetes

Objective:To investigate the relationship between urinary microalbuminuria(UMA) and waist to hip ratio(WHR),waist to height ratio(WHtR) and body mass index(BMI) in patients with type 2 diabetes mellitus(T2DM).Methods:Based on the results of BMI,292 T2DM patients were divided into normal weight group(n=88),overweight group(n=121) and obesity group(n=83).The levels of 24 h UMA were compared between three groups,and the impact factors of UMA were analyzed.Results:There were significant differences in values of BMI,WHR,WHtR,UMA and diastolic pressure(DBP) between three groups(P < 0.05 or P < 0.01).The correlation analysis showed a positive correlation between UMA and the duration of the disease,WHtR,WHR,BMI,systolic blood pressure(SBP) and DBP(P < 0.05 or P < 0.01).The multiple stepwise regression analysis showed that WHtR and SBP were independent risk factors of UMA(P < 0.05 or P < 0.01).Conclusion:The possibility of having UMA was significantly increased in T2DM patients with higher WHtR.The abdominal obesity is the risk factor of UMA in T2DM patients.