不同糖代谢状态下血清同型半胱氨酸水平与微量清蛋白尿的关系研究

发布时间：2018-05-11 20:27

本文选题：糖尿病 + 型　；参考：《中国全科医学》2017年S2期

【摘要】：目的探讨在不同糖代谢状态下血清同型半胱氨酸(Hcy)水平与微量清蛋白尿(MAU)的关系。方法连续入选自2014年3月—2016年6月北京邮电大学社区卫生服务中心就诊的患者,依据不同的糖代谢水平及是否伴有MAU将研究对象分为5组:糖耐量正常(NGT)组240例,糖调节受损(IGR)组230例,IGR伴MAU组(IGR+MAU组)31例,2型糖尿病(T2DM)组180例,T2DM伴MAU组(T2DM+MAU组)55例。记录各组患者的一般情况,包括性别、年龄、病程;记录入选者的身高、体质量、收缩压及舒张压,计算体质指数(BMI);检测各组患者的血清生化指标、Hcy水平及尿微量清蛋白与尿肌酐比(ACR)。采用Pearson相关分析及多因素Logistic回归分析MAU发生的影响因素。结果 5组舒张压、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)水平比较,差异均无统计学意义(P0.05);5组BMI、收缩压、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、Hcy、ACR比较,差异均有统计学意义(P0.05)。其中IGR+MAU组收缩压、FPG、HbA_(1c)、Hcy、ACR较NGT组和IGR组升高,差异均有统计学意义(P0.05);T2DM组BMI较NGT组升高,差异有统计学意义(P0.05);T2DM+MAU组BMI、TG、LDL-C水平较NGT组升高,收缩压、FPG、HbA_(1c)、Hcy、ACR较NGT组和IGR组升高,差异均有统计学意义(P0.05)。Pearson相关分析结果显示,IGR+MAU组患者MAU与BMI、收缩压、HbA_(1c)、Hcy均呈正相关(r=0.48、r=0.47、r=0.51、r=0.77,P均0.05)。多因素Logistic回归分析结果显示,BMI、T2DM病程、收缩压、FPG、HbA_(1c)及Hcy是发生MAU的独立危险因素(P0.05)。结论 BMI、T2DM病程、收缩压、FPG、HbA_(1c)及Hcy是发生MAU的独立危险因素。
[Abstract]:Objective to investigate the relationship between serum homocysteine (HCH) and microalbuminuria (MAU) in different glucose metabolism. Methods the patients selected from March 2014 to June 2016 in the Community Health Service Center of Beijing University of posts and Telecommunications were divided into five groups according to their glucose metabolism levels and whether they were accompanied by MAU: 240 patients with normal glucose tolerance (NGT) group. There were 30 cases of IGR with MAU MAU and 31 cases of type 2 diabetes mellitus (T2DM) in the group of impaired glucose regulation (IGR). There were 55 cases of T2DM MAU in the group of T2DM with MAU. The general information of each group was recorded, including sex, age, course of disease, height, body mass, systolic blood pressure and diastolic blood pressure. Body mass index (BMI) was calculated and serum Hcy level and urinary albumin / creatinine ratio were measured. Pearson correlation analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of MAU. Results there was no significant difference in the levels of diastolic blood pressure (DBP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) in the 5 groups. There was no significant difference in BMIs, systolic blood pressure (SBP), fasting blood glucose level (FPG), glycosylated hemoglobin (HbA1C), triglyceride (TGG), low density lipoprotein cholesterol (LDL-CU) ACR in 5 groups. The difference was statistically significant (P 0.05). The level of BMITGLDL-C in IGR MAU group was significantly higher than that in NGT group and IGR group, and the difference was statistically significant (P 0.05). The difference was statistically significant. The level of BMITGLDL-C in MAU group was higher than that in NGT group, and that in SBP group was higher than that in NGT group and IGR group, and the level of BMITGLDL-C in T2DM group was significantly higher than that in BMI group and IGR group, and the level of BMITG-LDL-C in MAU group was higher than that in NGT group, and that in P0.05T2DM group was higher than that in NGT group and IGR group, and the level of BMITG-LDL-C in T2DM group was significantly higher than that in control group (P < 0.05). The difference was statistically significant (P 0.05). Pearson correlation analysis showed that there was a positive correlation between MAU and BMI, systolic blood pressure (SBP) and HbA1C in patients with IGR MAU. The results of multivariate Logistic regression analysis showed that the course of BMI-T2DM, systolic blood pressure (SBP) and Hcy were independent risk factors for MAU. Conclusion the course of BMI-T2DM, systolic blood pressure (SBP) and Hcy are independent risk factors for the occurrence of MAU.
【作者单位】：北京邮电大学社区卫生服务中心;北京市丰台区新村社区卫生服务中心;
【分类号】：R587.2;R692.9

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