临床荟萃

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2型糖尿病肾病与血清胆红素的关系

  

  1. 1. 玉溪市人民医院 内分泌科,云南 玉溪 653100;2.河北医科大学第三医院 内分泌一科,河北 石家庄 050051
  • 出版日期:2017-09-05 发布日期:2017-09-08
  • 通讯作者: 通信作者:周园媛,Email:943157026@qq.com

Relationship between serum bilirubin and type 2 diabetic nephropathy

  1. 1. Department of Endocrinology,   People’s Hospital of Yuxi,  Kunming Medical University,   Yuxi 653100,  China;
    2. First Department of Endocrinology,  the Third Hospital of Hebei Medical University,
      Shijiazhuang 050051,  China
  • Online:2017-09-05 Published:2017-09-08
  • Contact: Corresponding author:Zhou Yuanyuan,Email:943157026@qq.com

摘要: 目的 通过研究2型糖尿病肾病患者血清胆红素浓度水平以探讨其在微血管病变的临床意义。方法 选取2型糖尿病患者525例,以尿白蛋白肌酐比值(ACR)为分组依据,分为正常白蛋白尿组(尿ACR正常:即 男<2.5 mg/mmol,女<3.5 mg/mmol)299例;早期糖尿病肾病组(尿ACR  男:2.5~30.0 mg/mmol,女3.5~30.0 mg/mmol)116例;临床糖尿病肾病组(尿ACR>30 mg/mmol且排外肾衰竭患者)110例。比较3组患者血清胆红素水平的差异。应用非条件Logistic逐步回归法对其危险因素进行多因素分析。结果 临床糖尿病肾病组血清总胆红素,直接胆红素,间接胆红素,较早期糖尿病肾病组、正常白蛋白尿组均低(P<0.05)。非条件Logistic逐步回归法显示血清总胆红素是糖尿病肾病的保护因素。结论 血清总胆红素水平与2型糖尿病肾病的进展呈负相关。

关键词: 糖尿病肾病, 氧化应激, 胆红素, 尿白蛋白与肌酐比值

Abstract: Objective  To explore the relationship between bilirubin level and diabetic neohropathy(DN).Methods  A total of 525 patients with type 2 diabetes mellitus(T2DM) were selected and divided into three groups according to  urinary albumintocreatinine ratio (ACR):  normal group(ACR in men<2.5 mg/mmol,ACR in women<3.5 mg/mmol)  in 299 cases;early diabetic nephropathy group (ACR in men 2.530.0 mg/mmol,ACR in women 3.530.0 mg/mmol)  in 116 cases;clinical diabetic nephropathy group (ACR>30 mg/mmol.  Exclusions were patients with renal failure)  in 110 cases. General data and serum bilirubin level were compared and analyzed among three groups.Results  The serum total bilirubin(TBIL),direct bilirubin and indirect bilirubin in normal group were all lower than those in early diabetic nephropathy group and normal group(P<0.05).Logistic regression analysis showed that TBIL was a protective factor for DN.Conclusion  Serum TBIL level is negatively correlated with the progression of  DN  in T2DM patients.

Key words: diabetic nephropathies, oxidative stress, bilirubin, urinary albumintocreatinine ratio