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高盐摄入促进糖尿病合并高血压患者肾脏早期损害的研究

The relationship of high sodium intake and early renal damage in diabetic patients with hypertension

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【作者】 龚柳平; 孙芳; 周训美; 李英莎; 何洪波; 祝之明;

【Author】 Gong Liuping;Sun Fang;Zhou Xunmei;Department of Hypertension & Endocrinology,Institute of Surgery Research,Daping Hospital,Third Military Medical University;

【机构】 第三军医大学大坪医院野战外科研究所高血压内分泌科;

【摘要】 目的 探讨糖尿病合并高血压患者高盐摄入与肾脏早期损害的关系。方法 对341例2型糖尿病合并高血压患者测定24 h尿钠、尿微量白蛋白及血脂谱、血尿酸等相关生化指标,根据公式将尿钠换算成摄盐量。用单因素方差分析患者基本资料相关分析摄盐量与尿蛋白关系、Logistic回归分析评估尿微量白蛋白的潜在危险因素。结果 根据摄盐量检测结果,将患者分为低摄盐组、低中摄盐组、中高摄盐组和高摄盐组。高摄盐组尿微量白蛋白显著高于低摄盐组(P<0.05);24 h尿钠、腰围、收缩压(SBP)、血尿酸、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)与尿微量白蛋白呈正相关(P<0.05),Logistic回归分析结果显示24 h尿钠、SBP、尿酸、糖化血红蛋白是24 h尿微量白蛋白增高的独立危险因素。结论 高盐摄入和高尿酸血症促进糖尿病合并高血压患者肾脏早期损害。

【Abstract】 Objective To investigate the relationship between high sodium intake and early renal damage in diabetic patients with hypertension.Methods 24-hour urinary sodium excretion,urinary microalbumin,lipid profiles and serum uric acid were measured in 341 diabetic patients with hypertension.Daily sodium intake was derived from 24-hour urinary sodium excretion.Baseline characteristics of the patients were compared by one-way analysis of variance(ANOVA).Pearson correlation analysis was used to determine the relation between sodium intake and urinary microalbumin,and logistic regression analysis was performed to assess the potential risk factors influencing urinary microalbumin.Results All patients were divided into 4 groups as low-,low-medium-,medium-high-,and high-sodium intake groups,according to quartiles of the sodium intake.Urinary microalbumin was significantly increased in high-sodium intake group compared with low-sodium intake group(P <0.05).The 24-hour urinary sodium excretion,waist circumference,systolic blood pressure(SBP),serum uric acid,low-density lipoprotein cholesterol(LDL-C)and total cholesterol(TC) were found to be positively correlated with urinary microalbumin(P <0.05).Furthermore,the 24-hour urinary sodium excretion,SBP,serum uric acid,and HbA1 c were found to be the independent risk factors for increased urinary microalbumin.Conclusion High sodium intake and hyperuricemia promote early renal damage in diabetic patients with hypertension.

【基金】 国家重点基础研究发展(973)计划(2012CB517805)
  • 【文献出处】 临床内科杂志 ,Journal of Clinical Internal Medicine , 编辑部邮箱 ,2016年05期
  • 【分类号】R587.1;R544.1
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