發(fā)布時(shí)間：2018-05-11 20:27

  本文選題：糖尿病 + 型��； 參考：《中國(guó)全科醫(yī)學(xué)》2017年S2期

【摘要】：目的探討在不同糖代謝狀態(tài)下血清同型半胱氨酸(Hcy)水平與微量清蛋白尿(MAU)的關(guān)系。方法連續(xù)入選自2014年3月—2016年6月北京郵電大學(xué)社區(qū)衛(wèi)生服務(wù)中心就診的患者,依據(jù)不同的糖代謝水平及是否伴有MAU將研究對(duì)象分為5組:糖耐量正常(NGT)組240例,糖調(diào)節(jié)受損(IGR)組230例,IGR伴MAU組(IGR+MAU組)31例,2型糖尿病(T2DM)組180例,T2DM伴MAU組(T2DM+MAU組)55例。記錄各組患者的一般情況,包括性別、年齡、病程;記錄入選者的身高、體質(zhì)量、收縮壓及舒張壓,計(jì)算體質(zhì)指數(shù)(BMI);檢測(cè)各組患者的血清生化指標(biāo)、Hcy水平及尿微量清蛋白與尿肌酐比(ACR)。采用Pearson相關(guān)分析及多因素Logistic回歸分析MAU發(fā)生的影響因素。結(jié)果 5組舒張壓、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)水平比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);5組BMI、收縮壓、空腹血糖(FPG)、糖化血紅蛋白(HbA_(1c))、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、Hcy、ACR比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。其中IGR+MAU組收縮壓、FPG、HbA_(1c)、Hcy、ACR較NGT組和IGR組升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);T2DM組BMI較NGT組升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);T2DM+MAU組BMI、TG、LDL-C水平較NGT組升高,收縮壓、FPG、HbA_(1c)、Hcy、ACR較NGT組和IGR組升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。Pearson相關(guān)分析結(jié)果顯示,IGR+MAU組患者M(jìn)AU與BMI、收縮壓、HbA_(1c)、Hcy均呈正相關(guān)(r=0.48、r=0.47、r=0.51、r=0.77,P均0.05)。多因素Logistic回歸分析結(jié)果顯示,BMI、T2DM病程、收縮壓、FPG、HbA_(1c)及Hcy是發(fā)生MAU的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論 BMI、T2DM病程、收縮壓、FPG、HbA_(1c)及Hcy是發(fā)生MAU的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the relationship between serum homocysteine (HCH) and microalbuminuria (MAU) in different glucose metabolism. Methods the patients selected from March 2014 to June 2016 in the Community Health Service Center of Beijing University of posts and Telecommunications were divided into five groups according to their glucose metabolism levels and whether they were accompanied by MAU: 240 patients with normal glucose tolerance (NGT) group. There were 30 cases of IGR with MAU MAU and 31 cases of type 2 diabetes mellitus (T2DM) in the group of impaired glucose regulation (IGR). There were 55 cases of T2DM MAU in the group of T2DM with MAU. The general information of each group was recorded, including sex, age, course of disease, height, body mass, systolic blood pressure and diastolic blood pressure. Body mass index (BMI) was calculated and serum Hcy level and urinary albumin / creatinine ratio were measured. Pearson correlation analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of MAU. Results there was no significant difference in the levels of diastolic blood pressure (DBP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) in the 5 groups. There was no significant difference in BMIs, systolic blood pressure (SBP), fasting blood glucose level (FPG), glycosylated hemoglobin (HbA1C), triglyceride (TGG), low density lipoprotein cholesterol (LDL-CU) ACR in 5 groups. The difference was statistically significant (P 0.05). The level of BMITGLDL-C in IGR MAU group was significantly higher than that in NGT group and IGR group, and the difference was statistically significant (P 0.05). The difference was statistically significant. The level of BMITGLDL-C in MAU group was higher than that in NGT group, and that in SBP group was higher than that in NGT group and IGR group, and the level of BMITGLDL-C in T2DM group was significantly higher than that in BMI group and IGR group, and the level of BMITG-LDL-C in MAU group was higher than that in NGT group, and that in P0.05T2DM group was higher than that in NGT group and IGR group, and the level of BMITG-LDL-C in T2DM group was significantly higher than that in control group (P < 0.05). The difference was statistically significant (P 0.05). Pearson correlation analysis showed that there was a positive correlation between MAU and BMI, systolic blood pressure (SBP) and HbA1C in patients with IGR MAU. The results of multivariate Logistic regression analysis showed that the course of BMI-T2DM, systolic blood pressure (SBP) and Hcy were independent risk factors for MAU. Conclusion the course of BMI-T2DM, systolic blood pressure (SBP) and Hcy are independent risk factors for the occurrence of MAU.
【作者單位】： 北京郵電大學(xué)社區(qū)衛(wèi)生服務(wù)中心;北京市豐臺(tái)區(qū)新村社區(qū)衛(wèi)生服務(wù)中心;
【分類號(hào)】：R587.2;R692.9

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