摘要
目的比较2型糖尿病合并或不合并周围神经病变患者的肾小球滤过率(GFR),分析2型糖尿病患者周围神经病变(DPN)与GFR的关系。方法收集2型糖尿病患者1131例,测定1131例2型糖尿病患者的神经转导速度,将其分为无神经病变组(n=734),合并周围神经病变组(n=397)。比较两组之间的基本情况和GFR。并将所有患者按尿白蛋白/肌酐比值(UACR)分为正常蛋白尿组901例,微量蛋白尿组183例,大量蛋白尿组47例进行亚组分析,分别按有无周围神经病变进行GFR 3组间比较。结果两组间年龄、糖尿病病程、尿素氮(BUN)、血肌酐(Cr)、糖化血红蛋白(HbA1c)、糖化白蛋白(GA)、24h尿尿酸、24h尿蛋白、GFR、UACR、尿转铁蛋白、尿α1微球蛋白、尿IgG比较差异有统计学意义(P均<0.05)。不同UACR亚组间GFR之间比较差异有统计学意义(P均<0.05)。Spearman相关分析表明,GFR与年龄、糖尿病病程、高血压病程、收缩压(SBP)、腰围、臀围、HbA1c、BUN、Cr、血尿酸(SUA)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、24h尿蛋白、24h尿尿酸、空腹血糖(FPG)、餐后2h血糖(2hPPG)、尿转铁蛋白、尿α1微球蛋白、尿IgG呈正相关。Logistic回归分析显示,糖尿病病程(回归系数=0.049,P=0.010)、GFR(回归系数=-0.020,P=0.000)、UACR(回归系数=0.001,P=0.015)是糖尿病周围神经病变的独立危险因素。结论2型糖尿病合并周围神经病变的患者GFR降低。
Objective To comprehend relationship between diabetic peripheral neuropathy(DPN)and glomerular filtration rate(GFR)in patients got with type 2 diabetes,we performed the comparison of the GFR in type 2 diabetics with or without DPN.Methods One thousand and thirty one patients suffering from type 2 diabetes were screened and their nerve conduction velocity(NCV)were determined.The patients screened were subsequently divided into non-peripheral neuropathy group(n=734)and peripheral neuropathy group(n=397),and the basic condition and GFR were also compared.All patients were diagnosed via urinary albumin creatinine ratio(UACR),and the results displayed that 901 patients have got with normal urinary albumin,183 patients got with microalbuminuria and 47 patients got with macroalbuminuria.Whether the peripheral neuropathy(PN)exists in patients or not was detected by comparing the three groups respectively.Results The statistical analysis suggests that there were significant differences among age,courses,blood urea nitrogen(BUN),creatinine(Cr),glycated hemoglobin(HbA1c),glycated albumin(GA),uric acid of 24 hours,urine protein of 24 hours,GFR,UACR,urinary transferrin,uricα1 microglobulin and uric IgG(P<0.05).GFR of different UACR subgroups has been found to be statistical differences(P<0.05).According to Spearman analysis,GFR was positively related to age,course of diabetes,course of hypertension,systolic blood pressure(SBP),waist circumference,hip circumference,BUN,Cr,blood serum uric acid(SUA),triglyceride(TG),HDL-C,uric acid of 24 hours,urine protein of 24 hours,fasting plasma glucose(FPG),postprandial 2 hours blood glucose(2hPPG),urinary transferrin,uricα1 microglobulin and uric IgG.According to Logistic regression analysis,diabetes course(regression coefficient=0.049,P=0.010),GFR(regression coefficient=-0.020,P=0.000)and UACR(regression coefficient=0.001,P=0.015)were found to play the role of independent risk factors for the diabetic peripheral neuropathy.Conclusion GFR of type 2 diabetics coupled with peripheral neuropathy is present to be downtrend.
作者
沈娟
严士敏
赵秀丽
龚慧
徐旭凌
刘珉
郁红
陈凤玲
Shen Juan;Yan Shimin;Zhao Xiuli(Department of Endocrinology,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University,School of Medicine,Shanghai 201900,China)
出处
《医学研究杂志》
2020年第2期32-36,共5页
Journal of Medical Research
基金
国家自然科学基金资助项目(81600625)
上海申康中心临床科技创新基金资助项目(SHDC12015319)。
关键词
糖尿病周围神经病变
尿白蛋白肌酐比
肾小球滤过率
Diabetic peripheral neuropathy
Urinary albumin-to-creatinine ratio
Glomerular filtration rate
