摘要
目的:探讨非透析糖尿病肾病患者的营养状态与血清钙镁比值(Ca/Mg)的相关性。方法:选择2017年1月至2019年6月于上海市第八人民医院肾内科就诊非透析糖尿病肾病患者139例,根据其血清Ca/Mg大小分为:低Ca/Mg组(Ca/Mg≤3.5,n=32)、中Ca/Mg组(3.5<Ca/Mg<4.5,n=56)、高Ca/Mg组(Ca/Mg≥4.5,n=51)。检测各组患者生化指标,分析患者的营养状态与血清Ca/Mg的相关性。结果:随着Ca/Mg的升高,非透析糖尿病肾病患者白蛋白(Alb)、血红蛋白(Hb)水平呈升高趋势,主观综合营养评价法(SGA)评分中营养不良患者比例呈降低趋势,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,非透析糖尿病肾病患者血清Ca/Mg与年龄(r=-0.199)、高敏C反应蛋白(hsCRP)水平(r=-0.294)、尿素氮(BUN)水平(r=-0.328)、血清肌酐(SCr)水平(r=-0.366)负相关(P<0.05);与估算肾小球滤过率(eGFR,r=0.266)、全段甲状旁腺激素(iPTH,r=0.101)、Alb(r=0.193)及Hb水平(r=0.266)正相关(P<0.05);与性别、三酰甘油(TG)、胆固醇(TC)、尿白蛋白肌酐比值(ACR)等指标无显著相关性。多因素线性回归分析显示,非透析糖尿病肾病患者血清Ca/Mg与hsCRP水平及年龄负相关,与Alb、Hb及iPTH水平正相关(P<0.05)。多因素logistic回归显示,血清Ca/Mg与非透析糖尿病肾病患者营养不良的发生存在独立相关关系(HR=0.506,95%CI 0.267~0.961,P=0.038)。结论:非透析糖尿病肾病患者的营养状态与血清Ca/Mg相关,血清Ca/Mg可能是该类患者发生营养不良的独立危险因素。
Objective:To analyze the relationship between nutritional status and serum Ca/Mg ratio in patients with non-dialysis-dependent diabetic kidney disease.Methods:A total of 139 patients with non-dialysis diabetic kidney disease who visited Shanghai Eighth People’s Hospital from January 2017 to June 2019 were selected and divided into three groups according to serum Ca/Mg ratio:group A(≤3.5,n=32),group B(3.5-4.5,n=56)and group C(≥4.5,n=51).Biochemical indexes of patients in each group were detected,and the correlation between nutritional status and serum Ca/Mg ratio was analyzed.Results:With the increase of Ca/Mg ratio,the levels of albumin(Alb)and hemoglobin(Hb)significantly increased(P<0.05),while the proportion of malnourished patients in the subjective global assessment of nutrition(SGA)score showed a decreasing trend(P<0.05).Spearman correlation analysis showed that the serum Ca/Mg ratio was negatively correlated with age(r=-0.199),the level of high-sensitivity C-reactive protein(hsCRP,r=-0.294),blood urea nitrogen(BUN,r=-0.328)and serum creatinine(SCr,r=-0.366),and it was positively correlated with the level of eGFR(r=0.266),intact parathyroid hormone(iPTH,r=0.101),Alb(r=0.193)and Hb(r=0.266).The above correlations were all statistically significant(P<0.05).However,the serum Ca/Mg ratio had no correlation with gender and the levels of albumin/creatinine ratio(ACR),total cholesterol(TC),or triglyceride(TG).The multivariate linear regression analysis result showed that serum Ca/Mg ratio was negatively correlated with hsCRP level and age,but positively correlated with Alb,Hb,and iPTH levels.Multivariate logistic regression showed that the Ca/Mg ratio was independently associated with the risk of malnutrition in non-dialysis patients with diabetic kidney disease(HR=0.506,95%CI 0.267-0.961,P=0.038).Conclusions:Serum Ca/Mg ratio was correlated with nutritional status in non-dialysis patients with diabetic kidney disease,and it might be used for the assessment of nutritional status in patients with non-dialysis diabetic kidney disease.
作者
郭洁
袁利
汪年松
王锋
GUO Jie;YUAN Li;WANG Nian-song;WANG Feng(Department of Nephrology,the Eighth People’s Hospital,Shanghai 200235,China;Department of Nephrology,the Sixth People’s Hospital,Shanghai Jiao Tong University,Shanghai 200233,China)
出处
《中国临床医学》
2021年第6期957-962,共6页
Chinese Journal of Clinical Medicine
基金
国家自然科学基金(81770741)
上海市徐汇区肾内科高原学科项目(SHXH201720).
关键词
糖尿病肾病
慢性肾脏病
钙镁比值
营养状态
diabetic kidney disease
chronic kidney disease
Ca/Mg ratio
nutritional status
