论文部分内容阅读
目的了解糖尿病患者不同糖化血红蛋白(HbA1c)控制水平下尿微量白蛋白(mAlb)的关联情况,探讨糖尿病不同HbA1c控制水平与其肾脏功能损伤的关系。方法收集2013—2015年昆山市中医医院所有住院的2型糖尿病患者信息,采集人口学信息,测量身高、体重、血压等;检测空腹血糖、HbA1c、血脂、血肌酐、血尿酸及mAlb等指标。对HbA1c控制不良及其他因素与mAlb异常的关系采用单、多因素非条件logistic回归模型进行分析。结果 1 037例2型糖尿病患者中,男性556例,女性481例,年龄24~82岁。调查对象HbA1c平均水平为8.40%,控制在6.50%以下的比例为15.81%。mAlb水平中位数为21.10 mg/L(范围值为9.20~79.10 mg/L),>20.00 mg/L者537例,占总人数的51.78%。在校正年龄、性别、文化程度、吸烟、饮酒、病程、是否使用降糖药、高血压史、血脂异常、血肌酐、血尿酸及白细胞数等变量后,多因素logistic回归分析显示,HbA1c≥6.50%者mAlb升高的危险性是<6.50%者的1.60倍(OR=1.60,95%CI:1.10~2.32)。结论 HbA1c浓度控制不达标将增加糖尿病患者肾功能受损的危险性。
Objective To investigate the association of urinary microalbumin (mAlb) with control of hemoglobin A1c (HbA1c) in diabetic patients and to explore the relationship between the different levels of HbA1c and its renal dysfunction in diabetic patients. Methods The information of type 2 diabetic patients hospitalized in Kunshan Hospital of Traditional Chinese Medicine from 2013 to 2015 was collected and demographic information was collected to measure height, weight, blood pressure and other indicators. Fasting blood glucose, HbA1c, blood lipid, serum creatinine, serum uric acid and mAlb were detected. The relationship between HbA1c poor control and other factors and mAlb abnormalities was analyzed by single and multi-factor non-conditional logistic regression model. Results Among 1,037 patients with type 2 diabetes, 556 were male and 481 were female, ranging in age from 24 to 82 years. The average level of HbA1c in the surveyed subjects was 8.40% and the percentage of those who controlled below 6.50% was 15.81%. The median level of mAlb was 21.10 mg / L (ranged from 9.20 to 79.10 mg / L) and 537 cases were> 20.00 mg / L, accounting for 51.78% of the total. Multivariate logistic regression analysis showed that HbA1c≥6.50 (P <0.05) after adjusting for age, sex, educational level, smoking, drinking, duration of disease, whether hypoglycemic agents, history of hypertension, dyslipidemia, serum creatinine, The risk of elevated mAlb in% was 1.60 times <6.50% (OR = 1.60, 95% CI: 1.10 to 2.32). Conclusion HbA1c concentration control does not meet the standard will increase the risk of diabetic patients with impaired renal function.