血浆纤维蛋白原与糖尿病肾病的相关性研究

目的:探讨2型糖尿病（T2DM）患者血浆纤维蛋白原(FIB)与糖尿病肾病（DN）的相关性。 方法: 选取T2DM患者541例，根据24 h尿微量白蛋白(UMA)含量分为3组:D1~D3组。根据FIB水平分为4组:F1~F4组。 结果:D1、D2、D3组间病程、TG、Cr、尿酸（UA）、FIB、高血压患病率差异均有统计学意义(P均< 0.05)。FIB与年龄、TG、TC、LDL-C、Cr、UA、UMA、C反应蛋白（CRP）和高血压呈正相关(P均< 0.05)。与F1组和F2组相比，F3组和F4组发生DN的风险增加(P均< 0.05)，校正相关因素后，虽然OR逐渐减少，但发生DN的风险仍然是增加的。对FIB进行ROC曲线分析，曲线下面积（AUC）为0.624±0.026（95%CI为0.574~0.675），P<0.001，最佳临界值为2.90 g/L。 结论: T2DM患者FIB水平与DN具有相关性，FIB高水平可能是T2DM患者发生DN的危险因素。

Relationship between plasma fibrinogen concentration and diabetic nephropathy

Objective: To investigate the relationship between plasma fibrinogen (FIB) and diabetic nephropathy (DN) in T2DM patients. Methods: A total of 541 T2DM subjects were enrolled in this study. They were divided into 3 groups according to the micro albumin urine (UMA) content in 24 h, including D1, D2 and D3 group. And according to FIB, the patients were divided into F1， F2，F3 and F4 groups. Results: Statistically significant differences in duration, TG, Cr, UA, FIB and the prevalence rate of hypertension among the D1~D3 groups were found (P<0.05). The FIB level was significantly positively correlated with age, TG, TC, LDL-C, Cr, UA, UMA, CRP and the prevalence rate of hypertension (P< 0.05). Compared with F1 group and F2 group, risk of DN significantly increased in F3 group and F4 group(P< 0.05). After adjusting the related risk factors such as duration, TG, Cr, UA and the prevalence rate of hypertension, the ORs were attenuated but the risk of DN remained increasing. FIB was analyzed by ROC curve with the area under the curve (AUC) being 0.624 ± 0.026 (95%CI 0.574~0.675) (P<0.001) and the optimal critical value was 2.90 g/L. Conclusion: The FIB level in T2DM subjects is significantly associated with DN. The high FIB level may be one of the risk factors for DN in T2DM patients.