关键词: 糖尿病, 2型；肾功能不全；危险因素

Abstract: ObjectiveTo examine the risks of early progressive renal function decline in patients with type 2 diabetes mellitus(T2DM) with or without microalbuminuria and risk factors.MethodsA total of  170 T2DM patients were selected for prospective followup study. According to  24 h urinary microalbumin(UMA) levels， the patients were divided into two groups， nonalbuminuriagroup( 24 hUMA  030 mg/24 h)， and  UMA group(24 hUMA>30300  mg/24 h). At the end of the followup， the patients were subdivided into two groups by the glomerular filtration rate（GFR） fall per year: early progressive renal function decline subgroup(≥3.3% descent rate compared with initial estimated  GFR(eGFR)  and stable renal function subgroup(<3.3% descent rate per year compared with initial eGFR).The differences  between early progressive renal function decline subgroup and stable renal function subgroup were analyzed， including the general data:  T2DM duration， body mass index(BMI)， and the laboratory indexes: hemoglobin A1C(HbA1c)，liver function， renal function and others， respectively. ResultsThe proportion of early progressive renal function decline in microalbuminuria group was higher.In microalbuminuria group: early progressive renal function decline subgroup had higher systolic blood pressure(SBP)， pulse pressure(PP)， HbA1c and lower BMI compared with those of stable renal function subgroup. In nonalbuminuria group: early progressive renal function decline subgroup had lower HDLC  compared with that of stable renal function subgroup. ConclusionT2DM patients may present early progressive renal dysfunction. In T2DM patients without microalbuminuria，HDLC decline is a risk  for early progressive renal dysfunction.But， for  the patients with microalbuminuria， higher SBP， PP， HbA1c are the risks  of early progressive renal dysfunction.

Key words: diabetes mellitus, type 2, renal , insufficiency, risk factors