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目的探讨2型糖尿病患者尿白蛋白排出量与血脂代谢异常的关系。方法根据尿白蛋白排出率(UAER)将73例2型糖尿病患者分为正常白蛋白尿(UAER<20μg/min)、微量白蛋白尿(UAER 20~200μg/min)和大量白蛋白尿(UAER>200μg/min)3个亚组,并选择28例健康人作为正常对照组。所有研究对象测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)、脂蛋白a[LP(a)]。结果2型糖尿病各组FPG及HbA1c与正常对照组的差异有显著性意义(P<0.01),而2型糖尿病三组之间FPG及HbA1c的差异无统计学意义。方差分析显示,4组间TG,HDL-C,LDL-C,LP(a)的差异有显著意义(F分别为4.75,5.22,4.32,6.48;P<0.05或P<0.01)。多元线性回归分析显示,尿白蛋白排出量与TG和FPG成正相关(r2=0.196)。结论2型糖尿病患者血脂代谢异常与尿白蛋白排出率有一定的关系,血脂含量改变越明显,尿白蛋白排出率越高,血脂异常是糖尿病肾病的重要影响因素。
Objective To investigate the relationship between urinary albumin excretion and dyslipidemia in type 2 diabetic patients. Methods According to the urinary albumin excretion rate (UAER), 73 patients with type 2 diabetes were divided into normal albuminuria (UAER <20μg / min), microalbuminuria (UAER 20 ~ 200μg / min) and massive albuminuria > 200μg / min) three subgroups, and 28 healthy individuals were selected as the normal control group. All subjects were tested for fasting plasma glucose (FPG), HbAlc, TC, TG, HDL-C, LDL-C ), Apolipoprotein A1 (apoA1), apolipoprotein B (apoB), lipoprotein a [LP (a)]. Results There were significant differences in FPG and HbA1c between the two groups (P <0.01), but there was no significant difference between FPG and HbA1c in type 2 diabetes mellitus. Analysis of variance showed significant differences in TG, HDL-C, LDL-C, and LP (a) between the four groups (F = 4.75, 5.22, 4.32, and 6.48, respectively; P <0.05 or P <0.01). Multivariate linear regression analysis showed that urinary albumin excretion was positively correlated with TG and FPG (r2 = 0.196). Conclusions There is a certain relationship between the abnormal blood lipid metabolism and urinary albumin excretion rate in patients with type 2 diabetes mellitus. The more the blood lipid content changes, the higher the urinary albumin excretion rate is. The dyslipidemia is an important influencing factor in diabetic nephropathy.