被动吸烟对女性2型糖尿病患者尿清蛋白排泄率的影响

目的探讨被动吸烟对不吸烟的女性2型糖尿病患者尿清蛋白排泄率(UAE)的影响。方法对2009年6月—2011年4月在我院住院的521例不吸烟的女性2型糖尿病患者进行被动吸烟的调查,比较被动吸烟暴露者和非被动吸烟暴露者的基本资料、胰岛功能、血脂水平、炎症标志物〔C反应蛋白(CRP)、纤维蛋白原、白细胞计数〕和8 h UAE。被动吸烟暴露的定义是与吸烟的家人或同事接触至少5年。结果不吸烟的女性2型糖尿病患者中,294例(56.4%)为被动吸烟暴露者(暴露组),227例(43.6%)为非被动吸烟暴露者(非暴露组)。暴露组患者受教育年限显著短于非暴露组,差异有统计学意义(P<0.05),血CRP、纤维蛋白原水平和8 h UAE均显著高于非暴露组,差异有统计学意义(P<0.05),而血高密度脂蛋白胆固醇(HDL-C)水平则显著低于非暴露组,差异有统计学意义(P<0.05)。多元逐步回归分析显示,糖尿病病程、收缩压、CRP、胰岛素抵抗指数(HOMA-IR)和被动吸烟累积量是不吸烟的女性2型糖尿病患者8 h UAE的独立影响因子。结论被动吸烟会增加女性2型糖尿病患者的UAE、血CRP及纤维蛋白原水平,并加重血脂代谢紊乱。

Influence of Passive Smoking on Urine Albumin Excretion in Women Patients with Type 2 Diabetes Mellitus

Objective To investigate the influence of passive smoking on urine albumin excretion(UAE) in non-smoking women patients with type 2 diabetes mellitus(T2DM).Methods Survey of passive smoking was conducted in 521 non-smoking women patients with T2DM hospitalized in our department from June 2009 to April 2011.Basic information,pancreatic function,blood lipid,inflammation marker(CRP,fibrinogen and leukocyte count) and 8 h UAE were compared between passive smoking exposure group and passive smoking non-exposure group.Passive smoking was defined as exposure to smoking family members or colleagues for at least five years.Results Among the non-smoking women patients with T2DM,294 cases(56.4%) were exposed to passive smoking(exposure group) and 227(43.6%) cases were not exposed to passive smoking(non-exposure group).Years of education,CRP,fibrinogen and 8 h UAE of the exposure group were significantly higher than those of the non-exposure group(P<0.05),while the level of HDL-C was significantly lower than that of the non-exposure group(P<0.05).Multi-stepwise regression analysis showed that duration of diabetes,systolic blood pressure,CRP,HOMA-IR and cumulative exposure to passive smoking were independent factors for 8 h UAE in non-smoking women with T2DM.Conclusion Passive smoking can increase urine protein excretion,CRP and fibrinogen level,and can aggravate lipid metabolic disorder in women patients with T2DM.