| 张岱,郑茂,祝捷,等.新诊断2型糖尿病患者尿白蛋白排泄与胰岛素抵抗关系的研究[J].中国临床保健杂志,2022,25(4):477-480. |
| 新诊断2型糖尿病患者尿白蛋白排泄与胰岛素抵抗关系的研究 |
| Research on correlation between urinary albumin excretion and insulin resistance in newly diagnosed T2DM patients |
| 投稿时间：2022-04-10 |
| DOI：10.3969/J.issn.1672-6790.2022.04.009 |
| 中文关键词: 糖尿病,2型 胰岛素抗药性 白蛋白尿 危险因素 |
| 英文关键词: Diabetes mellitus,type 2 Insulin resistance Albuminuria Risk factors |
| 基金项目:中央高校基本科研业务费专项资金项目(WK9110000194) |
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| 中文摘要: |
| 目的 探讨新诊断2型糖尿病(T2DM)患者尿白蛋白排泄情况及其与胰岛素抵抗的关系。方法 选择新诊断的T2DM患者182例,按尿白蛋白肌酐比值(UACR)水平分为3组:U1组为UACR<30 mg/g,U2 组为30 mg/g≤UACR≤300 mg/g,U3组为UACR>300 mg/g。检测空腹血糖(FPG)、空腹胰岛素水平(FIns)、血 脂等指标,采用稳态模型评估的胰岛素抵抗指数(HOMA-IR)以及胰岛β细胞功能指数(HOMA-β)评估胰岛素 抵抗程度。结果 (1)3组患者体重指数、收缩压(SBP)、舒张压(DBP)、尿酸(UA)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL- C)、糖化血红蛋白(HbA1c)、FPG、FIns、HOMA-β、HOMA-IR均差异有统计学意义(P<0.05);(2)Pearson法显 示:UACR与HbA1c、SBP、DBP、TG、TC、LDL-C、FPG、FIns及HOMA-IR呈正相关(P<0.05),与HOMA-β及估算 的肾小球滤过率(eGFR)呈负相关(P<0.05);(3)二元logistic回归分析显示:HbA1c、SBP、TG是新诊断T2DM 患者发生白蛋白尿的影响因素,HOMA-IR及HOMA-β不是新诊断T2DM患者发生白蛋白尿的影响因素。结论 胰岛素抵抗与新诊断T2DM患者尿白蛋白排泄增加有关,但未发现胰岛素抵抗是新诊断T2DM患者发生白蛋 白尿的独立危险因素。 |
| 英文摘要: |
| Objective To explore the association between urinary albumin excretion and insulin resistance in newly diagnosed type 2 diabetes mellitus (T2DM) patients.Methods A total of 182 inpatients with newly diagnosed T2DM were selected and divided into three groups according to urinary albumin creatinine ratio (UACR):U1 group (UACR<30 mg/g),U2 group (30 mg/g≤UACR≤300 mg/g),U3 group (UACR>300 mg/g).Fasting plasma glucose levels (FPG),fasting insulin levels (FIns),plasma lipid levels and other parameters were assayed.Homeostasis model assessment-insulin resistance index (HOMA-IR) and islet β-cell function index (HOMA-β) were introduced to evaluate insulin resistance degree.Results (1) There were significant differences in body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure(DBP),uric acid (UA),triglyceride (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),glycosylated hemoglobin (HbA1c),FPG, FIns,HOMA-IR and HOMA-β among three groups (P<0.05).(2) Pearson analysis showed that UACR was positively correlated with HbA1c,SBP,diastolic blood pressure (DBP),TG,TC,LDL-C,FPG,FInsand HOMA-IR (P<0.05), while negatively correlated with HOMA-β and eGFR (P<0.05).(3) Binary logistic regression analysis indicated that HbA1c,SBP and TG were influential factors for albuminuria in newly diagnosed T2DM patients,while neither HOMA-IR nor HOMA-β.Conclusions Insulin resistance is related to increased urinary albumin excretion,nevertheless,but which is not independent risk factor for albuminuria in newly diagnosed T2DM patients. |
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