2型糖尿病患者腹腔内脏脂肪面积与尿白蛋白排泄率相关性分析

目的 观察2型糖尿病患者腹腔内脏脂肪面积(VA)与24 h尿白蛋白排泄率(24 h-UAE)的关系.方法 收集河北医科大学第三医院内分泌科住院的2型糖尿病患者一般临床资料、VA、腹部皮下脂肪面积(SA)、24 h-UAE、血脂、空腹血糖、糖化血红蛋白、胰岛素水平和肿瘤坏死因子(TNF)-α.根据VA的四分位数分为4组:A组(VA<131 cm2);B组(131 cm2≤VA<174 cm2);C组(174 cm2≤VA<218 cm2);D组(VA≥218 cm2).比较4组间24 h-UAE水平和大量蛋白尿患病率,同时分析VA 与对数lg(24 h-UAE)]的相关强度和线性关系.结果 C和D组的24 h-UAE大于A和B组,随着VA增加,大量蛋白尿患病率增加;VA与lg(24 h-UAE)存在相关(r=0.51);VA每增加100 cm2,lg(24 h-UAE)增加0.26个单位,校正相关因素的影响后VA每增加100 cm2,lg(24 h-UAE)增加0.15个单位.在校正性别、甘油三酯的影响后,C组与A组比较,发生大量蛋白尿的危险上升到2.75倍,D组与A组比较,发生大量蛋白尿的危险上升到3.87倍.结论 VA增加是24 h-UAE增多的危险因素,随着VA的增加,大量蛋白尿患病率增加.

Abstract：

Objective To decipher the association of visceral adiposity (VA) with 24-hour urinary albumin excretion (24 h-UAE) in type 2 diabetics.Methods We collected the clinical data, VA, subcutaneous adiposity (SA), 24 h-UAE, blood lipids, fasting blood glucose, glycosylated hemoglobin, insulin and tumor necrosis factor (TNF)-α of type 2 diabetic inpatients at our hospital. According to the quartile of VA, the subjects were divided into 4 groups. And their profiles were compared with regards to the level of 24 h-UAE and the incidence of heavy proteinuria. And their relative intensities and the linear relationship of VA and lg (24 h-UAE) were analyzed.Results lg (24 h-UAE) of groups C and D was larger than that of groups A and B. With the rising level of VA, the prevalence of heavy proteinuria increased. A moderate correlation existed between VA and lg (24 h-UAE)(r=0.51).lg (24 h-UAE) increased 0.26 units as VA expanded 100 cm2, i.e. 0.15 units after relative factor adjusting. After gender and triglyceride adjusting, the odds ratio of heavy albuminuria in group C was 2.75 versus that in group A. And the OR was 3.87 in group D.Conclusion Expansion of VA is a risk factor for an elevated risk of 24 h-UAE. With the expansion of VA, the prevalence of heavy albuminuria increases.

Association of visceral adiposity with urinary albumin excretion in type 2 diabetics

Objective To decipher the association of visceral adiposity (VA) with 24-hour urinary albumin excretion (24 h-UAE) in type 2 diabetics.Methods We collected the clinical data, VA, subcutaneous adiposity (SA), 24 h-UAE, blood lipids, fasting blood glucose, glycosylated hemoglobin, insulin and tumor necrosis factor (TNF)-α of type 2 diabetic inpatients at our hospital. According to the quartile of VA, the subjects were divided into 4 groups. And their profiles were compared with regards to the level of 24 h-UAE and the incidence of heavy proteinuria. And their relative intensities and the linear relationship of VA and lg (24 h-UAE) were analyzed.Results lg (24 h-UAE) of groups C and D was larger than that of groups A and B. With the rising level of VA, the prevalence of heavy proteinuria increased. A moderate correlation existed between VA and lg (24 h-UAE)(r=0.51).lg (24 h-UAE) increased 0.26 units as VA expanded 100 cm2, i.e. 0.15 units after relative factor adjusting. After gender and triglyceride adjusting, the odds ratio of heavy albuminuria in group C was 2.75 versus that in group A. And the OR was 3.87 in group D.Conclusion Expansion of VA is a risk factor for an elevated risk of 24 h-UAE. With the expansion of VA, the prevalence of heavy albuminuria increases.