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目的探讨糖尿病慢性肾脏疾病(CKD)患者皮肤晚期糖基化终末产物(AGEs)水平变化及其临床意义。方法将96例T2DM患者按尿白蛋白/肌酐比值(UACR)分为正常白蛋白尿(NCKD)亚组、微量白蛋白尿(CKD1)亚组和大量白蛋白尿(CKD2)亚组,另选健康对照(NC)组32名,分别测定皮肤AGEs、HbA1c、UACR等指标。结果与NC组相比,T2DM组皮肤AGEs水平升高(P<0.01);与NCKD亚组相比,CKD亚组皮肤AGEs水平升高(P<0.05),且CKD2亚组皮肤AGEs水平高于CKD1亚组(P<0.05)。多元逐步回归分析显示,年龄、糖尿病病程是皮肤AGEs水平的独立相关因素。Logistic回归分析结果表明,皮肤AGEs水平、血压是CKD的独立相关因素(P<0.05)。结论皮肤AGEs水平可能参与CKD发病,可作为监测CKD发生、评估CKD程度的指标。
Objective To investigate the changes of advanced glycation end products (AGEs) in patients with chronic kidney disease (CKD) and their clinical significance. Methods Ninety-six T2DM patients were divided into three groups according to urinary albumin / creatinine ratio (UACR): subgroup of normal albuminuria (NCKD), subgroup of microalbuminuria (CKD1) and subgroup of massive albuminuria (CKD2) 32 healthy controls (NC) group were measured AGEs, HbA1c, UACR and other indicators. Results Compared with NC group, the level of AGEs in T2DM skin was increased (P <0.01). Compared with NCKD subgroup, the skin AGEs level in CKD subgroup was increased (P <0.05), and the level of AGEs in CKD2 subgroup was higher CKD1 subgroup (P <0.05). Multivariate stepwise regression analysis showed that age and duration of diabetes were independently associated with AGEs levels in the skin. Logistic regression analysis showed that skin AGEs level and blood pressure were independently correlated with CKD (P <0.05). Conclusion The level of AGEs in skin may be involved in the pathogenesis of CKD, which may be used as an indicator to monitor the occurrence of CKD and evaluate the degree of CKD.