初诊2型糖尿病患者尿蛋白的影响因素

目的探讨伴有微量白蛋白尿的初诊2型糖尿病患者尿白蛋白排泄率的相关影响因素。方法选择符合1999年WHO糖尿病诊断标准的初诊2型糖尿病患者60例,按尿白蛋白排泄率(UAER)分为单纯糖尿病组(DM组)和伴微量白蛋白尿组(DM UAER组),分别观察体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HLD)、低密度脂蛋白(LDL)、空腹胰岛素(FINS)、空腹C肽(FCPS)、胰岛素抵抗指数(HOMA-IR)等因素的组间差异及其与尿白蛋白排泄率的关系。结果①两组比较,DM UAER组WHR、FPG、2hPG、HOMA-IR均高于DM组,有显著性差异(P<0.05);②Pearson相关分析显示,UAER与FPG(r=0.521)、2hPG(r=0.397)、HOME-IR(r=0.26)成正相关(P<0.05);③多元逐步回归分析显示,FPG(r=0.521、P<0.01)是影响UAER的独立危险因素。结论伴有微量白蛋白尿的初诊2型糖尿病患者血糖和胰岛素抵抗水平高于不伴有微量白蛋白尿患者,空腹血糖是影响尿蛋白排泄率的独立危险因素。

Influential factors of urine albumin in newly diagnosed type 2 diabetic patients with microalbuminuria

Objective To explore the influential factors of urinary albumin excretion in newly diagnosed type 2 diabetic patients with microalbuminuria.Methods Sixty initially diagnosed type 2 diabetic patients were included in the present study,and divided into simple diabetic group(DM)and diabetic group with microalbuminuria(DM UAER)according to urinary albumin excretion rate(UAER).The body mass index(BMI),waist hip radio(WHR),fasting plasma glucose(FPG),2-hour plasma glucose(2hPG),glycated haemoglobin(HbA1c),triglycerides(TG),total cholesterol(TC),high density lipoprotein(HLD),low density lipoprotein(LDL),fasting serum insulin(FINS),fasting C peptide(FCPS),and homeostasis model assessment-insulin resistance index(HOMA-IR)in 2 groups were recorded and the relationship with UAER were observed.Results Compared with DM group patients,the WHR,FPG,2hPG and HOMA-IR were significantly higher in DM UAER group(P<0.05).Pearson correlation analysis revealed UAER was positively correlated with FPG(r=0.521),2hPG(r=0.397),HOME-IR(r=0.26)(P<0.05).Stepwise multiple regression analysis revealed that FPG(r=0.521,P<0.01)was independently influential factor of UAER.Conclusion The level of plasma glucose and the degree of insulin resistant in initially diagnosed type 2 diabetic patients with microalbuminuria are higher than those simple diabetic patients.Fasting plasma glucose is the independently influential factor of urinary albumin excretion.