血肌酐正常的2型糖尿病患者临床生化指标水平及其与肾功能的相关性

目的 探讨血肌酐(SCr)正常2型糖尿病患者临床生化指标水平及其对肾功能的影响。方法 选取2014年9月至2015年8月安徽省立医院SCr水平正常的2型糖尿病患者726例,根据美国慢性肾脏病及透析临床指南(NKF/DOQI)诊断标准将其分为肾功能正常组(A组)311例和肾功能受损组(B组)415例。比较两组患者年龄,病程,体重指数(BMI)等一般临床资料,记录患者的空腹血糖(FBG),糖化血红蛋白(HbA1c),总胆固醇(TC),三酰甘油(TG),低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),SCr,血尿素氮(BUN),血尿酸(UA),尿白蛋白肌酐比(UACR);采用Pearson相关分析,分析上述指标与肾功能的相关性。结果 B组患者的年龄,病程,肾功能指标(BUN、SCr、UA)及UACR水平明显高于A组,差异有统计学意义(P<0.05),糖代谢指标(FBG、HbA1c)B组明显低于A组,差异有统计学意义(P<0.05);Pearson相关分析提示肾小球滤过率估计值(eGFR)水平与年龄、病程、肾功能指标(BUN、SCr、UA)、UACR呈负相关,与糖代谢指标(FBG、HbA1c)呈正相关,差异有统计学意义(P<0.05),与BMI、脂代谢指标(TC、TG、HDL-C、LDL-C)无相关性(P>0.05)。结论 血肌酐正常的2型糖尿病患者中,年龄,病程,肾功能指标(BUN、SCr、UA)及UACR水平明显升高且与肾功能密切相关。

Correlation between clinical biochemical indexes and renal function in type 2 diabetes patients with normal serum creatinine

Objective To discuss the effect of clinical biochemical indexes on renal function in the type 2 diabetic patients with normal serum creatinine(SCr). Methods 726 patients with type 2 diabetes with normal SCr levels were enrolled and divided into the normal renal function group(Group A, 311 cases) and the impaired renal function group(Group B, 415 cases) according to the diagnostic criteria of NKF/DOQI clinical practice guidelines. Then, the clinical data such as age, disease course, body mass index(BMI) between the two groups were compared, and their blood levels of FBG, HbA1c, TC, TG, HDL-C, LDL-C, BUN, SCr, BUN, UA and UACR were examined and recorded. Correlation between the above indexes and the renal function was analyzed with the Pearson correlation analysis. Results There were significant differences between Group B and Group A in the age, disease course, FBG, HbA1c, BUN, SCr, UA and UACR(P<0.05), with higher indexes of renal function(BUN, SCr, UA) and lower indexes of glucose metabolism(FBG, HbA1c) in Group B. The correlation analysis showed that eGFR was negatively correlated with age, disease course, BUN, SCr, UA and UACR levels, but was positively correlated with FBG and HbA1c, and the differences among them were also significant(P<0.05). However, Estimated glomerular filtration rate(eGFR) was of no correlation with BMI and indexes of lipid metabolism(TC, TG, HDL-C, LDL-C). Conclusion For the type 2 diabetic patients with normal SCr, age, disease course, obvious elevation of indexes of renal function(BUN, SCr, UA) and UACR level would be closely related to renal function.