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2型糖尿病白蛋白尿与颈动脉内中膜厚度的关系探讨

于海雁,谢云   

  1. 天津医科大学代谢病医院5楼病房
  • 收稿日期:2010-01-25 修回日期:2010-04-20 出版日期:2010-11-15 发布日期:2010-11-15
  • 通讯作者: 于海雁

Discussion of the relationship between albuminuria and carotid artery intima-media thickness in type 2 diabetes mellitus

  • Received:2010-01-25 Revised:2010-04-20 Published:2010-11-15 Online:2010-11-15

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摘要： 目的：探讨2型糖尿病患者白蛋白尿与颈动脉内中膜厚度的关系。方法：将146例2型糖尿病（type 2 diabetes mellitus,T2DM）患者行24小时尿微量白蛋白检测，根据结果分为正常白蛋白尿组（86例）和异常白蛋白尿组（60例）（包括微量白蛋白尿组和大量白蛋白尿组），对两组患者分别进行各项生化指标及颈动脉内中膜厚度（intima-media thickness,IMT）的检测，并对两组数据进行单因素、多因素logistic回归分析，进一步经方差分析比较正常尿、微量白蛋白尿（micro - albuminuria,MAU）以及大量白蛋白尿三组间颈动脉IMT的差异。结果：①单因素logistic回归显示病程、视网膜病变发生率、甘油三酯（triglyceride,TG）、颈动脉IMT和血肌酐（creatinine,Cr）是2型糖尿病白蛋白尿的危险因素；②多因素logistic回归示病程长、甘油三酯高、颈动脉内中膜厚度增厚、血肌酐增高是2型糖尿病患者白蛋白尿的独立危险因素(OR值分别为 1.105,1.528.12.781,1.029)。③方差分析结果显示: 正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组三组间颈动脉IMT均数比较，差异有统计学意义(P=0.000)，而微量白蛋白尿组与大量白蛋白尿组之间比较差异无统计学意义（P=0.805）。结论：2型糖尿病患者颈动脉IMT是白蛋白尿的一个独立危险因素（OR=12.871），糖尿病肾病的严重程度与颈动脉IMT无明显相关性（P=0.805）。

关键词: 2型糖尿病, 颈动脉内中膜厚度, 糖尿病肾病, 微量白蛋白尿, 白蛋白尿

Abstract: to discuss the relationship between albuminuria and carotid artery intima-media thickness (IMT) in type 2 diabetes mellitus.Methods: 146 type 2 diabetes mellitus (T2DM) patients with 24-hour urine microalbumin detection,who based on the results were divided into normal albuminuria group (86 cases) and abnormal albuminuria group (60 cases) (including micro - albuminuria(MAU) group and macroalbuminuria group) .Two groups of patients were carried out on various biochemical indices and carotid artery intima-media thickness (IMT) detection, and two sets of data were analyzed by the single factor, multi-factor logistic regression analysis.Further compare the difference of carotid IMT among the three groups of normal urine, microalbuminuria and macroalbuminuria by variance analysis. Results: ①Single-factor logistic regression analysis showed that duration, the incidence of retinopathy, triglyceride (TG), carotid artery intima-media thickness (IMT) and serum creatinine (Cr) were the risk factors of albuminuria; ②multi-factors logistic regression showed longer duration, higher triglycerides, carotid artery intima-media thickness thickening, increased serum creatinine in patients with type 2 diabetes were the independent risk factors of albuminuria.(the OR values were 1.105,1.528,12.781,1.029respectively).③variance analysis showed: Among the three groups including normal albuminuria group, microalbuminuria group, macroalbuminuria, the difference of carotid artery IMT was statistically significant (P = 0.000), while there were no statistically significant difference between the groups of microalbuminuria and macroalbuminuria (P = 0.805). Conclusion: In patients with type 2 diabetes, carotid artery IMT is an independent risk factor of albuminuria(OR = 12.871), while the severity of diabetic kidney disease and carotid IMT was no significant correlation (P = 0.805).

Key words: type 2 diabetes mellitus, intima-media thickness, diabetic nephropathy, microalbuminuria, albuminuria