2型糖尿病患者动态动脉硬化指数与尿白蛋白/肌酐比值的关系

目的探讨2型糖尿病患者动态动脉硬化指数(ambulatory arterial stiffness index,AASI)与尿白蛋白/肌酐比值的关系。方法纳入152例糖尿病患者,其中合并高血压者82例,11例无糖尿病、高血压者为正常对照,进行24 h动态血压监测,计算AASI,并检测尿白蛋白、肌酐,计算尿白蛋白/肌酐比值(ACR)。检测血脂,血肌酐等指标,计算肾小球滤过率(GFR)。结果糖尿病合并高血压患者的AASI、ACR高于非合并高血压者(P0.05)。正常对照组、正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组糖尿病患者的AASI分别为(0.33±0.07),(0.46±0.12),(0.57±0.10),(0.74±0.08),两两相比均有差异(P0.05)。AASI≥0.55组与AASI0.55组的糖尿病患者的ACR相比增高(P0.05)。(2)单因素分析显示AASI与ACR呈正相关(r=0.692,P=0.000),与GFR负相关(r=-0.16,P=0.042);多元回归分析发现AASI仅与ACR正相关。结论 2型糖尿病患者合并高血压患者的AASI高于非合并高血压患者,AASI与ACR有关。

Relationship Between Ambulatory Arterial Stiffness Index and Urinary Albumin to Creatinine Ratio in Patients With Type 2 Diabetes

Objective To understand the relationship between ambulatory arterial stiffness index（ASSI） and urinary albumin to creatinine ratio（ACR） in patients with type 2 diabetes.Methods A total of 152 patients with type 2 diabetes were included,in which 82 were with hypertension,and 11 hypertension cases without diabetes were included as control.Ambulatory blood pressure monitoring was performed and AASI was calculated.ACR,lipid,creatinine were measured,and glomerular filtration rate（GFR）was calculated.Results ① AASI,ACR were higher in diabetic subjects with hypertension than in diabetic subjects without hypertension（P〈0.05）.The AASIs of control group,the normal urinary albumin group,micro urinary albumin group and clinical urinary albumin group were（0.33±0.07）,（0.46±0.12）,（0.57±0.10） and（0.74±0.08）,respectively.Significant differences were observed among them（P〈0.05）.ACR was higher in diabetic subjects with AASI ≥0.55 than in diabetic subjects with AASI〈 0.55（P〈0.05）.② AASI was positively correlated with ACR（r=0.692,P=0.000）,and negatively correlated with GFR（r=-0.16,P=0.042）.However,only positive correlation was showed in line regression analysis.Conclusion AASI was higher in diabetic subjects with hypertension than in diabetic subjects without hypertension.AASI is correlated with ACR.