河北医科大学学报

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不同年龄及体重2型糖尿病患者肾小球滤过率影响因素分析

  

  1. 1.河北省眼科医院内科，河北 邢台 054000；2.复旦大学附属中山医院内分泌科，
    上海 200032；3.河北省邢台市中医院疼痛科，河北 邢台 054000
  • 出版日期:2020-03-25 发布日期:2020-04-02
  • 作者简介:郭哲(1982-)，男，河北邢台人，河北省眼科医院主治医师，医学学士，从事内科疾病诊治研究。
  • 基金资助:
    邢台市科技计划项目(2017ZC068)

Analysis of factors influencing glomerular filtration rate in type 2 diabetes mellituspatients with different age and weight#br#

  1. .Department of General Internal Medicine, Hebei Eye Hospital, Xingtai 054000, China；
    2.Department of Endocrinology, Zhongshan Hospital,Fudan University， Shanghai
    200032, China; 3.Department of Pain Treatment, Xingtai Traditional Chinese
    Medical Hospital, Hebei Province, Xingtai 054000, China
  • Online:2020-03-25 Published:2020-04-02

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摘要： ［摘要］
目的  观察不同年龄及体重2型糖尿病患者肾小球滤过率（estimating glomerular filtration rate，eGFR）的变化情况，分析代谢参数与肾小球滤过率的相关性。
方法  收集糖尿病患者207例及非糖尿病者68例，应用改良MDRD公式计算eGFR，以年龄分组，多重比较分析每组间eGFR差异情况并分析与其他代谢参数相关性，并进行线性回归分析；进一步以40~70岁年龄患者组，以不同体重指数（body mass index，BMI）分组，分析各组间差异情况。
结果  随着年龄的增长，BMI、天冬氨酸转氨酶（glutaminc oxalacetic transaminase，AST）、丙氨酸转氨酶（glutamic pyruvic transaminase，ALT）、尿酸（uric acid，UA）、eGFR均是下降的，各年龄组组间eGFR存在差异(P＜0.001)；Pearson相关性分析结果提示，eGFR与BMI、三酰甘油(triglyceride，TG）、ALT、AST、谷氨酰转肽酶（gamma-glutamyl transpeptidase,GGT）、UA呈正相关，与性别、同型半胱氨酸（homocysteine,HCY）、糖化血红蛋白（hemoglobin A1c,HbA1c）、25-羟维生素D（25-hydroxyvitamin-D,25（OH）D）呈负相关。线性回归分析结果提示，BMI、TG、ALT（P＜0.001）与eGFR独立正相关；AST、GGT、UA、HbA1c、HCY、25（OH）D（P＜0.001）与其独立负相关。相近年龄患者以不同BMI分组，随着BMI增加，eGFR逐渐增高，组间多重比较显示肥胖组与体重正常组组间比较eGFR差异有统计学意义（P＜0.001），严重肥胖组与其他各组间eGFR差异均有统计学意义(P＜0.001)。
结论  随着年龄增长，2型糖尿病患者代谢水平及eGFR降低，AST、25（OH）D、UA、HCY为肾损伤的独立危险因素。年龄相近患者，肥胖患者eGFR水平高。

关键词: 糖尿病, 2型, 肥胖症, 肾小球滤过率

Abstract: ［Abstract］ ObjectiveTo observe the changes of glomerular filtration rate(eGFR) in hospitalized type 2 diabetes mellitus patients with different age and weight,and analyze the relationship between metabolic parameters with it.
〖WTHZ〗MethodsTwo hundred and seven diabetics and 68 non-diabetics information was collected. The eGFR was calculated by the modified MDRD formula. The differences of eGFR between each group were analyzed by multiple comparisons and the correlation between eGFR and other metabolic parameters was analyzed. Linear regression analysis was carried out. Further, the patients aged 40-70 were divided into different body mass index(BMI) groups to analyze the differences between the groups.
〖WTHZ〗ResultsWith the increase of age, BMI, glutaminc oxalacetic transaminase(AST）, glutamic pyruvic transaminase（ALT），  uric acid（UA）  and eGFR decreased.There was significant difference in eGFR among age groups(P＜0.001). Pearson correlation analysis showed that eGFR was positively correlated with BMI, triglyceride(TG), ALT, AST, gamma-glutamyl transpeptidase(GGT), UA, and negatively correlated with gender, homocysteine(HCY), hemoglobin A1c(HbA1c), 25 hydroxyvitamin D25(OH)D. Further linear regression analysis showed that BMI, TG, ALT  were positively correlated with eGFR(P＜0.001), and AST, GGT, UA, HbA1c, Hcy, 25(OH) D  were negatively correlated with it(P＜0.001). Patients of similar age were divided into different BMI groups. With the increase of BMI, eGFR increased gradually. There was significant difference in eGFR between obese group and normal weight group(P＜0.001). The difference of eGFR among severly obese and other groups was statisically significant(P＜0.001).
〖WTHZ〗ConclusionWith the increase of age, the metabolic level and eGFR of type 2 diabetic patients decrease. AST, 25（OH） D, UA and HCY are independent risk factors of renal injury. The obese patients have high levels of eGFR, as patients of similar ages.

Key words: diabetes mellitus, type 2, obesity, glomerular filtration rate

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