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【目的】探讨肥胖对2型糖尿病(T2DM )患者尿白蛋白排泄的影响。【方法】选择本科收治的T2DM 患者105例,根据体质量指数(BMI ,kg/m2)分为正常组(40例,18≤ BMI <24)、超重组(29例,24≤BMI <28)、肥胖组(36例,BMI ≥28)三组,比较三组患者24 h 尿微量白蛋白(mALB),随机尿微量白蛋白/肌酐(ACR)等相关指标水平;同时以腰臀比(WHR)分为肥胖组(51例,男 WHR >0.90,女 WHR >0.80 )、正常组(54例男 WHR ≤0.90,女 WHR ≤0.80 ),比较两组患者 mALB 、ACR 等相关指标水平。【结果】①根据BMI 分组,正常组 mALB 和 ACR 为[(100.98±70.42)mg/24 h 和(99.24±69.88)mg/g];超重组 mALB 和ACR 为[(214.37±102.69)mg/24 h 和(208.5±71.35)mg/g];肥胖组 mALB 和 ACR 为[(467.77±330.86) mg/24 h 和(424.49±131.38)mg/g];均较正常组明显升高,差异具有统计学意义( P < 0.05)。②根据 WHR分组,正常组 mALB 和 ACR 为[(132.06±98.98)mg/24 h 和(127.90±84.53)mg/g],肥胖组 mALB 和 ACR为[(406.37±312.09)mg/24 h 和(373.32±152.02)mg/g],较正常组明显升高,差异具有统计学意义( P <0.05)。【结论】mALB 、ACR 随 BMI 及 WHR 增高而增高,控制肥胖有利于预防糖尿病肾病(DN )的发生及延缓病程的进展。“,”Objective] To explore the effects of obesity on excretion of urine protein in type 2 diabetics .[Meth‐ods] A total of 105 type 2 diabetics were enrolled and divided into normal weight ( n = 40 ,18 ≤ BMI 0 .80) and normal control ( n = 54 ,male WHR ≤ 0 .90 ,female WHR ≤ 0 .80) groups for comparing the levels of mAlb and ACR .[Results] According to BMI ,24h Um‐Alb and ACR in overweight group (214 .37 ± 102 .69 ;208 .5 ± 71 .35)and obesity group (467 .77 ± 330 .86 ;424 .49 ± 131 .38) were markedly higher than that in normal weight group (100 .98 ± 70 .42 ;99 .24 ± 69 .88)( P < 0 .05) .According to WHR ,24h Um‐Alb and ACR significantly increased in obesity group versus normal control group (406 .37 ± 312 .09 ;373 .32 ± 152 .02 vs 132 .06 ± 98 .98 ;27 .90 ± 84 .53)( P < 0 .05) .[Conclusion]The levels of mAlb and ACR increase with greater BMI and WHR in type 2 diabetics .And obesity control may prevent the occurrence of diabetic nephropathy and delay progression .