摘要
目的探讨铁代谢指标与T2DM及糖尿病早期肾损伤之间的关系。方法确诊为T2DM的住院患者,依据尿白蛋白与肌酐比值(ACR)水平分为单纯糖尿病(DM)组、早期糖尿病肾脏疾病(EDN)组、S临床糖尿病肾脏疾病(DN)组,选取门诊健康体检者为对照(NC)组,检测ACR,血清铁(Fe)、铁蛋白(Ferr)、总铁结合力(TIBC)、转铁蛋白饱和度(TS)、转铁蛋白(Tf)、尿素(Urea)、Cr及HbA_1c水平,估算肾小球率过滤(eGFR)。结果各组随着ACR水平升高,Ferr、Fe、TS、HbA_1c均升高(P<0.01)。相关性分析显示,ACR水平与HbA_1c、Ferr、Fe、Tf均呈正相关(r=0.867、0.685、0.613、0.754,P<0.01);HbA_1c与Ferr、Fe、Tf呈正相关(r=0.506、0.668、1.000,P<0.01)。多元逐步回归分析显示,与ACR水平密切相关的因素为HbA_1c、Ferr、TS及病程。结论 T2DM及糖尿病肾脏疾病(DKD)早期患者即存在铁代谢异常,铁负荷增加糖尿病及早期肾损伤风险。HbA_1c、Ferr、TS可作为T2DM患者血糖控制情况及DKD早期发现的有价值的动态监测指标。
Objective To explore the relationship between iron metabolic indexes with type 2 diabetes mellitus（T2DM） and early diabetic renal injury. Methods Hospitalized patients with T2DM were enrolled in this study and divided into 3 groups： simple diabetes mellitus group（DM）, early diabetic nephropathy group（EDN）,and diabetic kidney disease group（DN）. Outpatient subjects with health check- ups were selected as control group. Urinary albumin creatinine rate （ACR）, serum iron （Fe）, ferritin （Ferr） ,total iron binding capacity（TIBC）, transferring（Tf）, transferring saturation（TS）, urea, creatinine （Cr） and glycosylated hemoglobin Alc（HbAlc） were tested and the estimated glomerular filtration rate （eGFR） were calculated in all the subjects. Results Ferr,Fe,TS, and HbAlc levels increased with the increase of ACR in each group（all P-0.01）. Correlation analysis indicated that ACR level was positively correlated with HbA1 c, Ferr, Fe, and TS（r= 0. 867,0. 685,0. 613,0. 754, P〈0.01）. HbA1 c level was positively correlated with Ferr and TS（r=0. 506,0. 668,P〈0.01）. Multiple stepwise regression analysis showed that HbA1c, Ferr,and TS were closely related factors for UACR. Conclusion T2DM and early diabetic nephropathy had abnormal iron metabolism. Iron load increased the risk of diabetes and early renal injury. HbAlc,Ferr, and TS could be used as a valuable dynamic monitoring indicator in blood glucose control and early detection o{ DN in patients with T2DM.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2017年第10期882-885,共4页
Chinese Journal of Diabetes
关键词
铁代谢
糖尿病
2型
糖尿病肾脏疾病
尿白蛋白/肌酐比值
糖化血红蛋白
估算肾小球滤过率
Iron metabolism
Diabetes mellitus, type 2
Diabetic kidney disease
Urinary albumin creatinine rate
Glycosylated hemoglobin Alc
Estimated glomerular filtration rate
