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目的探讨2型糖尿病患者血清镁离子水平与24 h尿微量白蛋白的关系。方法选取1 167例2型糖尿病患者,排除明显可能影响血镁水平相关情况后入选510例患者,其中男319例,女191例,年龄18～64岁,接受血电解质、糖脂代谢、肾功能及3次24 h尿微量白蛋白等检查。结果 (1)男性糖尿病非肾病组的血清镁离子水平显著高于糖尿病肾病Ⅲ期和Ⅳ期组,差异有统计学意义[(0.89±0.07)mmol/L vs.(0.86±0.08)mmol/L、(0.82±0.06)mmol/L,P<0.01];而女性中虽然差异无统计学意义,但可见到相同趋势。(2)将男、女人群的血镁值分为4分位数,男性血镁水平位于25%位点者的24 h尿微量白蛋白水平高于血镁位于50%～75%位点者和75%位点者,差异有统计学意义[13.26(5.84～90.84)mg/24 h vs.8.48(4.85～19.50)mg/24 h和7.25(5.48～12.44)mg/24 h,P<0.05];糖化血红蛋白水平高于血镁位于50%～75%位点者和75%位点者,差异有统计学意义[(9.8±2.5)%vs.(8.9±2.3)%和(8.4±2.2)%,P<0.05]。女性位于血镁25%位点者的糖化血红蛋白高于其他组,各组24 h尿微量白蛋白间未见明显差异。(3)相关分析显示,男性的血镁水平分别与24 h尿微量白蛋白(相关系数为-0.177,P<0.01)和糖化血红蛋白(相关系数为-0.201,P<0.01)相关;女性的血镁水平与糖化血红蛋白相关,而与24 h尿微量白蛋白无相关关系。(4)Logistic回归分析显示,收缩压(β=0.073,P=0.000)和血镁水平(β=-8.699,P=0.027)为影响男性尿微量白蛋白的主要因素;收缩压、三酰甘油、空腹血糖等为影响女性尿微量白蛋白的主要因素。结论血镁水平较低的男性2型糖尿病患者,24 h尿微量白蛋白水平较高。血镁水平可能作为男性尿微量白蛋白的标志。
Objective To investigate the relationship between serum magnesium level and 24-hour urinary albumin in type 2 diabetic patients. Methods A total of 1 167 patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. 510 patients were excluded from the study, including 319 males and 191 females, aged 18-64 years. Blood electrolytes, glucose and lipid metabolism, renal function And 3 times 24h urine microalbumin and other tests. Results (1) The level of serum magnesium in male diabetic non-nephritic group was significantly higher than that in stage Ⅲ and Ⅳ diabetic nephropathy ([0.89 ± 0.07] mmol / L vs. (0.86 ± 0.08) mmol / L , (0.82 ± 0.06) mmol / L, P <0.01]. However, there was no significant difference among the women, but the same trend was observed. (2) Divided the blood magnesium values of men and women into four quartiles, and the 24 h urinary albumin levels of males with blood magnesium levels at 25% were higher than that of those with blood magnesium levels between 50% and 75% And 75%, respectively, with significant difference [13.26 (5.84-90.84) mg / 24 h vs.8.48 (4.85- 19.50) mg / 24 h and 7.25 (5.48-12.44) mg / 24 h, P <0.05 (9.8 ± 2.5)% vs (8.9 ± 2.3)% and (8.4 ± 2.2)%, respectively; the level of HbA1c was higher than that of blood magnesium in 50% ~ 75% of the patients and 75% of the patients )%, P <0.05]. Women with glycated hemoglobin at 25% of serum magnesium levels were higher than the other groups, and there was no significant difference between 24-hour urine microalbumin groups. (3) The correlation analysis showed that the level of serum magnesium in males was correlated with 24-hour urinary albumin (correlation coefficient -0.177, P <0.01) and HbA1c (correlation coefficient -0.201, P <0.01) Magnesium levels were associated with HbA1c and no correlation with 24 h urine microalbumin. (4) Logistic regression analysis showed that systolic blood pressure (triglyceride, triglyceride, triglyceride, triglyceride, triglyceride, , Fasting blood glucose and other factors affecting female microalbuminuria. Conclusions Male patients with type 2 diabetes who have low serum magnesium levels have a higher 24-hour urine microalbumin level. Magnesium levels may serve as a hallmark of male urine microalbumin.