2型糖尿病肾病患者血糖波动与肾功能和氧化应激的相关性分析

目的　探讨2型糖尿病肾病患者血糖波动与肾功能和氧化应激的相关性分析。方法　选取2019年1月至2022年1月济南市第二人民医院收治的2型糖尿病患者82例，其中单纯2型糖尿病28例（单纯2型糖尿病组）、2型糖尿病肾病54例（2型糖尿病肾病组），另选取17例健康者为健康组。单纯2型糖尿病组患者中，男14例，女14例，年龄31~68（49.52±8.52）岁，吸烟5例；2型糖尿病肾病组患者中，男33例，女21例，年龄30~70（50.52±8.61）岁，吸烟3例；健康组中男10例，女7例，年龄30~80（52.52±8.77）岁，吸烟3例；收集研究对象的临床资料，比较3组研究对象的血糖波动指标（24 h平均血糖标准差、平均血糖波动幅度），采用全自动生化分析仪测定肾功能尿素氮（BUN）、肌酐（SCr），比较3组患者氧化应激活性氧（ROS）、超氧化物歧化酶（SOD）水平。采用t、χ²检验和单因素方差分析，采用Pearson法分析2型糖尿病肾病患者血糖波动与肾功能和氧化应激的相关性。结果　与健康组相比，单纯2型糖尿病组、2型糖尿病肾病组患者24 h平均血糖标准差、平均血糖波动幅较高（F=26.446、49.198，均P<0.001），2型糖尿病肾病组高于单纯2型糖尿病组，两组比较差异有统计学意义（均P<0.05）。与健康组相比，单纯2型糖尿病组、2型糖尿病肾病组患者BUN、SCr较低（F=17.541、16.524，均P<0.001），2型糖尿病肾病组低于单纯2型糖尿病组（均P<0.05）。与健康组相比，单纯2型糖尿病组、2型糖尿病肾病组患者ROS、SOD较低（F=21.250、18.522，均P<0.001），2型糖尿病肾病组低于单纯2型糖尿病组（均P<0.05）。Pearson结果显示，BUN、SCr、ROS、SOD与2型糖尿病肾病平均血糖波动幅度呈负相关（r=-0.365、-0.687、-0.854、-0.257，P=0.012、0.021、0.015、0.010）。结论　2型糖尿病肾病患者血糖波动与肾功能和氧化应激呈现负相关。

Correlations of blood glucose fluctuation with renal function andoxidative stress in patients with type 2 diabetes nephropathy

Objective　To explore the correlations of blood glucose fluctuation with renalfunction and oxidative stress in patients with type 2 diabetes nephropathy. Methods　Eighty-two patients with type 2 diabetes treatedat Jinan Second People's Hospital from January 2019 to January 2022 weredivided into a simple type 2 diabetes group (28 cases) and a type 2 diabetesnephropathy group (54 cases); 17 healthy people were selected as a healthygroup. The clinical data were collected and compared. In the simple type 2diabetes group, there were 14 males and 14 females who were 31-68 (49.52±8.52)years old, with 5 smokers. In type 2 diabetes nephropathy group, there were 33males and 21 females who were 30-70 (50.52±8.61) years old, with 3 smokers. Inthe healthy group, there were 10 males and 7 females who were 30-80(52.52±8.77) years old, with 3 smokers. The 24 h mean blood glucose standarddeviations and mean blood glucose fluctuation ranges of the three groups werecompared. The blood urea nitrogen (BUN) and creatinine (SCr) were measured bythe automatic biochemical analyzer. The levels of reactive oxygen species (ROS)and superoxide dismutase (SOD) of the three groups were compared. t and χ² tests and one-way ANOVA were applied. The Pearsonmethod was used to analyze the correlations of blood glucose fluctuation withrenal function and oxidative stress in the patients with type 2 diabetesnephropathy. Results　The 24 h mean bloodglucose standard deviations and the mean blood glucose fluctuation ranges inthe simple type 2 diabetes group and the type 2 diabetes nephropathy group werehigher those in the healthy group (F=26.446and, 49.198, both P<0.001), andthose in the type 2 diabetes nephropathy group were higher than those in thesimple type 2 diabetes group, with statistical significance (both P<0.05). The BUN and SCR in thesimple type 2 diabetes group and the type 2 diabetes nephropathy group werelower than those in the healthy group (F=17.541and 16.524, both P<0.001), andthose in the type 2 diabetes nephropathy group were lower than those in thesimple type 2 diabetes group (both P<0.05).The ROS and SOD in the simple type 2 diabetes group and the type 2 diabetesnephropathy group were lower than those in the healthy group (F=21.250 and 18.522, both P<0.001), and the levels in the type2 diabetes nephropathy group were lower than those in the simple type 2 diabetesgroup (both P<0.05). Pearson'sresults showed that BUN, SCR, ROS, and SOD were negatively correlated with themean blood glucose fluctuation of the patients with type 2 diabetes nephropathy(r=-0.365, -0.687, -0.854, and-0.257; P= 0.012, 0.021, 0.015, and0.010). Conclusion　There are negativecorrelations of blood glucose fluctuation with renal function and oxidativestress in patients with type 2 diabetes nephropathy.