【摘要】 目的探讨糖耐量减低(IGT)患者早期糖尿病肾病的预测指标、患病率及影响因素。方法262例受试者中正常糖耐量(NGT)103人、IGT98人、糖尿病(DM)61人,全部进行即刻尿转铁蛋白/肌酐(UTRF/Cr)和尿白蛋白/肌酐(UAlb/Cr)的检测及临床观察指标的测定。结果(1)UTRF/Cr与UAlb/Cr呈显著正相关,r=0.618,P<0.001。(2)IGT组的UAlb/Cr(中位数,极差)、UTRF/Cr(中位数,极差)高于NGT组(0.015,0.44mg/mg比0.012,0.58mg/mg,t=-1.981,P=0.049;0.064,4.96mg/mg比0.034,7.30mg/mg,t=-2.249,P=0.026)。(3)各组UTRF/Cr比值的阳性率明显高于白蛋白尿的阳性率(41.6%比29.7%,P<0.01)。(4)Logistic回归分析显示白蛋白尿的主要危险因素是DBP,OR=1.064,2hPGOR=1.109,P<0.01;非糖尿病组的主要危险因素是DBP,OR=1.064,P<0.01。结论在IGT阶段已存在早期糖尿病肾脏损害,高血压是其重要的危险因素。尿转铁蛋白/肌酐比值的检测较白蛋白尿/肌酐比值更灵敏,但仍需进一步综合比较二者的敏感性和特异性。更多还原

【Abstract】 Objective To investigate the prevalence,predictable markers and risk factors for early diabetic nephropathy(DM). Methods Urinary transferrin-to-creatinine ratio (UTRF/Cr) and urinary albumin-to-creatinine ratio (UALB/Cr) and other clinical parameters such as waist circumference,blood pressure,body mass index(BMI) and lipids were measured in 262 subjects (103 subjects with NGT,98 with IGT,61 with DM). Results 1. UTRF/Cr was positively related with UALB/Cr (r=0.618,P<0.001). 2.Both UALB/Cr(Median,range) and UTRF/Cr(Median,range) were significantly higher in IGT group than in the NGT group(0.015,0.44 mg/mg vs 0.012,0.58 mg/mg,t=-1.981,P=0.049;0.064,4.96mg/mg vs 0.034,7.30mg/mg,t=-2.249,P=0.026). 3.The positive rate of UTRF/Cr was significantly higher than that of microalbuminuria (41.6% vs 29.7%,P<0.01). 4. Logistic regression analysis showed that diastolic blood pressure (OR 1.064,95%CI 1.003-1.097,P<0.001) and 2h plasma glucose (OR 1.109,95%CI 1.032-1.191,P<0.001) were risk factors for the development of microalbuminuria in all groups,while diastolic pressure (OR 1.064,95%CI 1.028-1.101,P<0.01) was the only risk factor in nondiabetic subjects. Conclusions The prevalence of early diabetic nephropathy is high even in the stage of IGT. Hypertension is a main risk factor for the development of DN. UTRF/Cr is more sensitive than UALB/Cr for detecting diabetic nephropathy.更多还原