血清总胆红素与2型糖尿病肾病的相关性研究

摘要

目的：探寻血清总胆红素（TB）与2型糖尿病肾病的相关性。方法将126例住院2型糖尿病患者按尿白蛋白排泄率（UAER）将其分为正常蛋白尿组、早期糖尿病肾病组、临床糖尿病肾病组，比较三组血清TB 水平及其他临床生化资料，探寻血清 TB 与 UAER 的相关性，并采用多因素 Logistic 回归分析探讨糖尿病肾病发病的影响因素。结果三组间年龄、体质量指数（BMI）、舒张压（DBP）、尿酸（UA）、总胆固醇（TCH）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（HbA1 c）比较差异均无统计学意义（P ＞0．05），糖尿病病程、收缩压（SBP）、TB 在不同组间差异有统计学意义（P ＜0．05）。Spearman 相关分析显示血清 TB 与 UAER显著负相关（r ＝－0．32，P ＜0．01）。Logistic 多元回归分析显示 BMI 和 TB 是糖尿病肾病的独立影响因素（OR ＝1．189、0．850；P ＜0．05、P ＜0．01）。结论血清 TB 与2型糖尿病肾病呈负相关，其可能成为糖尿病肾病的一种新治疗靶点。%Objective To explore the relationship between serum total bilirubin(TB)and diabetic nephropathy in patients with type 2 diabetes.Methods A total of 126 hospitalized patients with type 2 diabetes were including and divided into three groups according to urinary albumin excretion rate(UAER):normal albuminuria group,early phase diabetic nephropathy group,and clinical diabetic nephropathy group.The serum TB and other clinical and biochemical assessment data were recorded and compared between three groups.The relationship between serum TB and UAER was analyzed.The risk factors of diabetic nephropathy was evaluated by multiple logistic regression analysis.Results There was no significant difference in the age,BMI,DBP,UA,TCH,TG,LDL-C,HbA1 c among three groups(P >0. 05).There were significant difference among the groups in the diabetic duration,SBP and TB (P <0.05).The analy-sis of spearman showed that the level of serum TB was negatively associated with UAER(r =-0.32,P <0.01).Logis-tic regression analysis showed that BMI and TB were independent influence factors of diabetic nephropathy(OR =1. 189,0.850;P <0.05,P <0.01,respectively).Conclusion The serum TB may be a protective factor for diabetic ne-phropathy in type 2 diabetic patients,which might be a potential therapeutic target for diabetic nephropathy.