2型糖尿病患者尿微量白蛋白/尿肌酐比值与血糖波动的影响因素分析*

Influence factors of urinary microalbumin / creatinine ratio and blood glucose fluctuation in patients with type 2 diabetes*

摘要:

目的 探讨2型糖尿病患者尿微量白蛋白/尿肌酐比值（uACR）与血糖波动的影响因素。方法 选取339例确诊的2型糖尿病患者，应用动态血糖监测系统监测血糖，收集其临床资料。首先依据平均血糖波动幅度（MAGE）分组，MAGE<3.9?mmol/L 99例（血糖波动正常组），MAGE≥3.9?mmol/L 240例（血糖波动异常组），分析影响血糖波动的因素；再依据uACR分组，uACR<30?mg/g 197例（uACR正常组），uACR≥30?mg/g 142例（uACR异常组），分析影响uACR的因素。结果 血糖波动正常组与血糖波动异常组比较，病程、空腹血糖、糖化血红蛋白、总胆固醇、中性粒细胞/淋巴细胞比值（NLR）、uACR差异有统计学意义（P?<0.05）。糖尿病病程[OlR=1.040（95% CI：0.958，1.758）]、总胆固醇[OlR=1.332（95% CI：1.061，1.672）]是血糖波动的影响因素。uACR正常组与uACR异常组比较，年龄、病程、低密度脂蛋白胆固醇、NLR、MAGE差异有统计学意义（P?<0.05）。病程[OlR=1.055（95% CI：1.014，1.096）]、NLR [OlR=2.186（95% CI：1.602，2.983）]、MAGE [OlR=1.438（95% CI：1.226，1.688）]是uACR的影响因素。结论 随着2型糖尿病患者病程的进展，血糖波动幅度逐渐增大，总胆固醇可影响血糖波动；随着病情的进展，机体的炎症反应增强，血糖波动幅度的增大可影响uACR。

Abstract:

Objective To investigate the influence factors of urinary microalbumin / creatinine ratio and blood glucose fluctuation in patients with type 2 diabetes. Methods Clinical data were collected from 339 patients diagnosed with type 2 diabetes and monitored by dynamic blood glucose monitoring system. Firstly, 99 patients with MAGE < 3.9 mmol/L (normal glucose fluctuation group) and 240 patients with MAGE≥ 3.9?mmol/L (abnormal glucose fluctuation group) were grouped according to the mean amplitude of glycemic excursions (MAGE). Then, uACR < 30 mg/g in 197 cases (uACR normal group), uACR ≥ 30 mg/g in 142 cases (uACR abnormal group) were divided into different group according to the ratio of urinary microalbumin to creatinine (uACR). The factors affecting uACR were analyzed. Results The differences in disease course, fasting blood glucose, glycosylated hemoglobin, cholesterol, NLR and uACR were statistically significant between normal blood glucose fluctuation group and abnormal group (P?