2型糖尿病住院患者合并慢性肾脏病相关因素研究 : = Chronic Kidney Disease in Hospitalized T2DM Patients

目的分析南昌地区2型糖尿病住院患者慢性肾脏病(CKD)患病率及相关因素。方法选取2013年1—5月南昌市第三医院内分泌代谢科收治的2型糖尿病患者456例,通过病历资料采集调查对象基本信息,计算估算肾小球滤过率(e GFR)=186×〔血肌酐(Scr)(μmol/L)/88.41〕-1.154×年龄-0.203×0.742(女性)×1.233,将调查对象按照e GFR≥90、60~<90、<60 ml·min-1·(1.73 m2)-1分为3组〔Ⅰ、Ⅱ、Ⅲ组〕,以e GFR<60 ml·min-1·(1.73 m2)-1定义为CKD。采用多元线性回归分析影响2型糖尿病住院患者合并CKD的因素。结果根据e GFR水平,分为Ⅰ组309例,Ⅱ组94例,Ⅲ组53例。3组患者性别、体质指数(BMI)、腰围(WC)、高密度脂蛋白胆固醇(HDL-C)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、代谢综合征(MS)、吸烟、饮酒、单用口服降糖药物比例比较,差异均无统计学意义(P>0.05);3组年龄、餐后2 h血糖(2 h PG)、尿酸(UA)、e GFR、糖尿病病程、收缩压(SBP)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、Scr、24 h尿蛋白定量、心血管疾病(CVD)、脑卒中病史、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体阻滞剂(ARB)使用情况、单用胰岛素、口服降糖药物与胰岛素联合使用率比较,差异均有统计学意义(P<0.05)。Pearson相关分析显示,年龄、SBP、UA与e GFR呈负相关(r=-0.51、-0.29、-0.48,P<0.05),FPG、2 h PG、TG与e GFR呈正相关(r=0.18、0.12、0.12,P<0.05)。多元线性回归分析结果显示,年龄、SBP、UA、TG是影响2型糖尿病住院患者e GFR水平的因素(P<0.05)。不同MS组分数量e GFR水平比较,差异有统计学意义(F=4.540,P=0.004),其中MS组分数量=1时e GFR水平高于MS组分数量=2、3、4者(P<0.05)。456例患者中合并CKD者53例(11.6%)。不同性别、BMI、是否合并MS、血脂紊乱、中心性肥胖CKD患病率比较,差异无统计学意义(P>0.05),不同年龄、糖尿病病程、是否合并高血压、高尿酸血症患者CKD患病率比较,差异有统计学意义(P<0.05)。结论南昌地区2型糖尿病住院患者中CKD患病率为11.6%,2型糖尿病合并CKD与年龄、SBP、UA和TG水平等因素有关。.

Objective To investigate the prevalence rate of chronic kidney disease( CKD) in patients with type 2diabetes mellitus( T2DM) and the factors associated with CKD progression. Methods A total of 456 T2 DM patients admitted to the 3rd Hospital of Nanchang from January to May 2013. The general information was collected. The definition criterion was estimated glomerular filtration rate( e GFR) = 186 × 〔Scr( μmol / L) /88. 41 〕- 1. 154× age- 0. 203× 0. 742( female) ×1. 233. The subjects were divided,according to e GFR levels,into groups Ⅰ 〔e GFR ≥90 ml · min- 1·( 1. 73 m2)- 1〕,Ⅱ〔60- < 90 ml·min- 1·( 1. 73 m2)- 1〕,Ⅲ 〔 < 60 ml·min- 1·( 1. 73 m2)- 1〕,and e GFR < 60 ml·min- 1·( 1. 73m2)- 1was defined as CKD. Multiple linear regression analysis was used to analyze the factors influencing CKD in T2 DM patients. Results According to e GFR levels,309 patients were divided into group Ⅰ,94 into group Ⅱ,53 into group Ⅲ.There was no significant difference among 3 groups in gender, BMI, WC, HDL- C, DBP, TC, TG, metabolic syndrome( MS),smoking,alcohol consumption,the proportion of single- use oral hypoglycemic drugs( P > 0. 05),there was in age,2 h postprandial glucose( 2 h PG),uric acid( UA),e GFR,diabetes duration,SBP,LDL- C,FPG,Hb A1 c,Scr,24 h urinary protein,cardiovascular disease( CVD),history of stroke,use of angiotensin converting enzyme inhibitors( ACEI) /angiotensin Ⅱ receptor blocker( ARB),single- use insulin,the proportion of combination with oral hypoglycemic agents and insulin( P < 0. 05). Pearson correlation showed that age,SBP,UA were negatively correlated with e GFR( r = 0. 51,- 0. 29,- 0. 48,P < 0. 05),FPG,2 h PG,TG positively with e GFR( r = 0. 18,0. 12,0. 12,P < 0. 05). Multiple linear regression analysis showed that age,SBP,UA,TG were factors influencing e GFR levels in hospitalized T2 DM patients( P < 0. 05).There was difference in e GFR level between different MS component numbers( F = 4. 540,P = 0. 004),e GFR levels were higher when MS component number = 1 than MS component number = 2,3,4( P < 0. 05). In 456 patients,53 were combined with CKD( 11. 6%). No difference was noted in CKD prevalence between patients of different genders, BMI, whether combined with MS,dyslipidemia,central obesity( P > 0. 05), there was difference in CKD prevalence between patients of different ages,diabetes durations,whether complicated by hypertension,hyperuricemia( P < 0. 05). Conclusion The CKD prevalence is 11. 6% in hospitalized T2 DM patients in Nanchang district. T2 DM combined with CKD may be related to age,SBP,UA,TG,etc..

Medienart:	E-Artikel

Erscheinungsjahr:	2015-03-15 2015
Erschienen:	2015-03-15

Enthalten in:	Zur Gesamtaufnahme - year:2015
Enthalten in:	Zhong guo quan ke yi xue - (2015), 08 vom: 15. März, Seite 893-897 Original Letters: Enthalten in 中国全科医学 (DE-600)2994737-6 (DE-600)2994737-6 河北省邯郸市

Reihe:	China Academic Journals (CAJ), E, 医药卫生科技 = Medicine & Public Health

Sprache:	Chinesisch

Weiterer Titel:	Chronic Kidney Disease in Hospitalized T2DM Patients

Beteiligte Personen:	杨枝 [VerfasserIn] 肖魏华 [Sonstige Person] 王丽娜 [Sonstige Person] 段鹏 [Sonstige Person] 涂萍 [Sonstige Person]

Links:	oversea.cnki.net [lizenzpflichtig]

Themen:	内分泌腺疾病及代谢病 内科学 医药、卫生 医药卫生科技 外科学 江西省南昌市第三医院内分泌代谢科 泌尿科学 Endocrine and Systemic Disease Medicine & Public Health Urology

Anmerkungen:	Author info:YANG Zhi;XIAO Wei-hua;WANG Li-na;Department of Endocrinology and Metabolism,the Third Hospital of Nanchang

Förderinstitution / Projekttitel:

PPN (Katalog-ID):	CAJ475840011