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目的探讨T2DM患者微量白蛋白尿(MAU)与无临床症状大血管病变的相关关系。方法选取在我院住院和门诊随访的资料完整的糖尿病患者190例(DM组),正常对照组22名(NC组)。所有研究对象进行人体学测量、生化指标测定及胰岛素释放试验以及血管彩超检查颈总动脉内-中膜厚度(CIMT)和下肢动脉内径等。应用稳态模型评估法(HOMA)及李光伟指数(IAI)评价IR。结果 CI-MT与下肢各动脉内径均呈负相关。CIMT及下肢动脉内径与年龄、病程、SBP、DBP、TG、TC、LDL-C、HbA1c、MAU、HOMA-IR呈正相关,与HDL-C、IAI呈负相关,与BMI无相关性。结论 T2DM伴MAU患者同时存在早期大血管病变,而且MAU排泄率越高,早期大血管病变越重。IR可能是T2DM患者MAU和早期大血管病变共同患病的基础。
Objective To investigate the relationship between microalbuminuria (MAU) and non-clinical macroangiopathy in patients with T2DM. Methods Totally 190 diabetic patients (DM group) and 22 normal controls (NC group) were enrolled in this study. All subjects for anthropological measurement, biochemical markers and insulin release test, and vascular color Doppler ultrasound intima-media thickness (CIMT) and lower extremity arterial diameter and so on. Application of HOMA and IAI to evaluate IR. Results CI-MT and the diameter of the lower extremity artery were negatively correlated. The diameters of CIMT and lower extremity arteries were positively correlated with age, course of disease, SBP, DBP, TG, TC, LDL-C, HbA1c, MAU and HOMA-IR, but negatively correlated with HDL-C and IAI. Conclusions There are both early macrovascular complications in patients with T2DM and MAU, and the higher the MAU excretion rate, the more severe the early macrovascular disease. IR may be the basis for the co-morbidity of MAU and early macrovascular disease in patients with T2DM.