摘要
目的通过分析住院2型糖尿病肾脏疾病(T2DKD)患者的血尿酸(UA)水平与肾功能不全的相关性,探讨血UA在防治T2DKD中的价值。方法测定2009年1月-2011年8月住院的2型糖尿病患者的血肌酐、血UA水平及24h尿白蛋白定量(24h-UAE)。应用简化肾脏病膳食改良试验(MDRD)公式估算肾小球滤过率(eGFR)。eGFR<60mL·min-1·1.73m-2被定义为肾功能不全。结果按2007年美国国立肾脏病基金会(NKF)的糖尿病及慢性肾脏疾病的临床诊断治疗指南,共入选T2DKD患者364例,男201例,女163例;平均年龄为(63±12)岁。血UA水平为(350±99)μmol/L;eGFR为(80±31)mL·min-1·1.73m-2。肾功能不全的发生率26.9%(98/364)。eGFR<60mL·min-1·1.73m-2组的血UA水平显著高于eGFR≥60mL·min-1·1.73m-2组(P<0.01)。单因素相关分析显示,血UA水平与eGFR呈负相关(r=-0.303,P<0.05)。微量白蛋白尿(MAU)的发生率为50.5%(184/364),大量白蛋白尿(CAU)的发生率为49.5%(180/364)。CAU组的血UA水平显著高于MAU组(P<0.01)。单因素相关分析显示,血UA水平与24h-UAE呈正相关(r=0.162,P<0.05)。Logistic回归分析显示,年龄(OR=1.116,95%CI为1.065～1.169,P<0.01)、24h-UAE(OR=1.001,95%CI为1.000～1.001,P<0.01)、血UA水平(OR=1.006,95%CI为1.001～1.011,P<0.05)是T2DKD患者发生肾功能不全的独立危险因素。结论为有效地延缓T2DKD病变的发展,临床工作中应积极控制血UA水平及尿白蛋白排泄量。
Objective To investigate the relationship of serum uric acid （UA） and renal dysfunction in hospitalized patients with type 2 diabetic kidney disease （T2DKD） and to assess the value of serum UA in T2DKD prevention and treatment. Methods From January 2009 to August 2011, serum creatinine, serum UA and 24-hour urinary albumin excretion {24h-UAE） of the hospitalized patients with type 2 diabetes mellitus were dectected in our hospital. Glomerular filtration rate （eGFR） was calculated by the modification of diet in renal disease {MDRD） equation. When eGFR was less than 60 mL · min^-1· 1.73 m-2, the patient was diagnosed as renal dysfunction. Results According to the Clinical Practice Guidelines for Diabetes and Chronic Kidney Disease suggested by National Kidney Foundation （NFK 2007）, 364 T2DKD patients were enrolled in the present study. There were 201 males and 163 females with an average age of （63- 12） years. The serum UA level was {350-1-99） lumol/L and eGFR was （80-31） mL · min^-1· 1.73 m-2. The prevalence of renal inadequacy was 26.9% {98/364）. Serum UA level in eGFR〈60 mL· min^-1· 1.73 m-2 patients was significantly higher than that in eGFR〈60 mL · min^-1· 1.73 m-2 patients （ P〈0.01）. Univariate correlation analysis demonstrated that serum UA level was negatively correlated with eGFR （ r = - 0. 303, P〈0.05）. The prevalence of microalbuminuria and macroalbuminuria was 50.5% （184/364） and 49. 5% （180/364）, respectively. Serum UA level in macroalbuminuric group was significantly higher than that in microalbuminuric group （P〈0.01）. Univariate correlation analysis demonstrated that serum UA level was positively correlated with 24h-UAE （r = 0. 162, P〈0. 05）. Multivariate Logistic regression analysis indicated that age （ OR = 1.116, 95 % OI ： 1. 065 - 1. 169, P〈0.01 ）, 24h-UAE （ OR = 1. 001, 95%CI：1.000-1.001, P〈0.01）, and serum UA （OR= 1. 006, 95%CI; 1.001- 1.011, P〈0.05） were independent factors of renal dysfunction in T2DKD patients. Conclusion Reduction of serum UA level and urinary albumin excretion can delay the development of renal lesions in T2DKD patients.
出处
《上海医学》
CAS
CSCD
北大核心
2013年第1期59-62,共4页
Shanghai Medical Journal
基金
上海市糖尿病重点实验室项目(08DZ2230200)
上海交通大学医学院科技基金项目(11XJ21058)资助
关键词
糖尿病肾脏疾病
尿酸
肾小球滤过率
Diabetic kidney disease
Serum uric acid
Glomerular filtration rate
