2型糖尿病患者尿微量白蛋白/肌酐比值与臂踝脉搏波传导速度的相关性
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南京市卫生局重点项目(ZKX10016)


Relationship Between Urinary Albumin Creatinine Ratio and Brachial-ankle Pulse Wave Velocity in Patients with Type 2 Diabetes Mellitus
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    摘要:

    目的 探讨2型糖尿病患者尿微量白蛋白/肌酐比值(UACR)与臂踝脉搏波传导速度(baPWV)的相关性,同时探讨其他可能影响baPWV的因素。方法 800例住院的2型糖尿病患者,行baPWV、UACR、血脂、肾功能、空腹血糖、空腹C肽、糖化血红蛋白、血钙磷、血甲状旁腺激素等测定。采用单因素方差分析及多元线性逐步回归分析评价baPWV与UACR及其他各因素相关情况。结果 2型糖尿病患者随着年龄增大,baPWV逐渐增大(P<0.001)。按UACR不同水平分为3组后,>300 mg/g组baPWV(1958.10±530.76 cm/s)较<30 mg/g组(1609.86±310.98 cm/s)、30~300 mg/g组(1659.88±354.27 cm/s)显著增大(均P<0.005)。Pearson相关分析显示,baPWV与年龄、收缩压、脉压差、血清尿素氮及UACR呈正相关(r=0.554、0.393、0.440、0.158、0.300,均P<0.05),与血清白蛋白、肾小球滤过率、血磷、钙磷乘积呈负相关(r=-0.195、-0.261、-0.203、-0.176,均P<0.05)。多元逐步线性回归分析显示,baPWV与年龄、收缩压、UACR呈独立正相关(β=0.488、0.266、0.143,t=14.55、8.12、4.47,均P<0.001),与血磷呈独立负相关(β=-0.083,t=-2.57,P<0.05)。结论 2型糖尿病患者baPWV与年龄、收缩压、UACR及血磷独立相关。

    Abstract:

    Aim To investigate the relationship between urinary albumin creatinine ratio (UACR) and brachial-ankle pulse wave velocity (baPWV) in type 2 diabetes patients. Methods A total of 800 type 2 diabetes mellitus (T2DM) patients were enrolled in a cross sectional study. baPWV, lipid, renal function, UACR, fasting C-peptide, glycosylated hemoglobin, serum calcium, serum phosphorus and parathyroid hormone were measured. The correlations between baPWV and parameters were analyzed. Results With the increased level of age, baPWV increased (P<0.001). UACR levels were classified into three groups. The mean baPWV in group of UACR>300 mg/g (1958.10±530.76 cm/s) was higher than group of UACR<30 mg/g (1609.86±310.98 cm/s) and UACR 30~300 mg/g (1659.88±354.27 cm/s), and the differences were statistically significant (both P<0.005). Pearson analysis showed that age, systolic blood pressure, pulse pressure difference, serum urea nitrogen and UACR were positively correlated with baPWV (r=0.554, 0.393, 0.440, 0.158, 0.300, all P<0.05), while serum albumin, estimated glomerular filtration rate, phosphorus and multiplication of calcium and phosphorus were negtively correlated with baPWV (r=-0.195,-0.261, -0.203, -0.176, all P<0.05). In the multiple linear step-down regression model with baPWV as the dependent variable, age, systolic blood pressure and UACR were positively associated with baPWV (β=0.488, 0.266, 0.143, t=14.55, 8.12, 4.47, all P<0.001), while phosphorus was inversely associated with baPWV (β=-0.083, t=-2.57, P<0.05). Conclusion BaPWV was independently associated with age, systolic blood pressure, UACR and serum phosphorus.

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孙燕军,俞仁艳,陈 炜,黄 洪,张天艳,荣 灿,胡 云.2型糖尿病患者尿微量白蛋白/肌酐比值与臂踝脉搏波传导速度的相关性[J].中国动脉硬化杂志,2014,22(5):489~494.

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  • 收稿日期:2012-12-31
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