| 刘君,杨艳君,韩伟.尿微量白蛋白与尿肌酐比值对 2型糖尿病合并非酒精性脂肪肝的影响[J].安徽医药,2021,25(8):1656-1659. |
| 尿微量白蛋白与尿肌酐比值对 2型糖尿病合并非酒精性脂肪肝的影响 |
| Effect of urinary microalbumin and urinary creatinine ratio on non-alcoholic fatty liver in pa? tients with type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2021.08.042 |
| 中文关键词: 糖尿病， 2型 脂肪肝 尿微量白蛋白 尿肌酐 |
| 英文关键词: Diabetes mellitus, type 2 Fatty liver Urinary microalbumin Urinary creatinine |
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| 中文摘要: |
| 目的检测 2型糖尿病( T2DM)病人尿微量白蛋白、尿肌酐、血脂、血清总胆固醇水平，探讨尿微量蛋白与尿肌酐比值对 2型糖尿病合并非酒精性脂肪肝的影响。方法选取 2018年 6月至 2019年 9月池州市人民医院收治的 2型糖尿病病人 120例，根据是否合并脂肪肝分为观察组( T2DM合并非酒精性脂肪肝)及对照组(单纯 T2DM)其中观察组 47例，对照组 73例，测并比较两组血液指标、血生化指标、尿微量白蛋白、尿肌酐( UCr)、三酰甘油( TG)、总胆固醇，(TC)及尿微量白蛋白 /UCr比值。检采用 Pearson相关性分析血脂指标与高尿微量蛋白 /UCr比值的关系。按照病人是否合并脂肪肝进行赋值(合并脂肪肝 =1，不合并脂肪肝 =0)绘制尿微量白蛋白与 UCr比值对脂肪肝诊断价值的 ROC曲线。结果观察组尿微量白蛋白［ 45.48(32.57，49.38)mg/L.84(25.68，36.34)mg/L］、尿微量白蛋白 /UCr［(56.42±10.35)mg/g比( 37.57±9.28)mg/g］、 TG［(3.12±1.05)mmol/L比( 2.05±1.84)mmol/L］、 TC［(6.28±2.35)mmol/L比( 4.96±2.14)mmol/L］、 HOMA-IR［3.89(1.86，4.29)比 2.74(1.51，3.75)］、 HDL-C［(1.98±0.68)mmol/L比( 0.96±0.49)mmol/L］尿酸［(354.36±25.39)mmol/L比( 249.63±26.14)mmol/L］显著高于对照组，差异有统比32，计学意义( P<0.05)。经 Pearson相关性分析、，TG、TC、HDL-C与高尿微量蛋白 /UCr比值呈正相关( r值分别为 0.770、0.694、0.765，P<0.05)。 LDL-C高尿微量蛋白 /UCr值无相关性( P>0.05)。 ROC曲线结果显示 AUC=0.892，95%CI(0.754~0.915)，因 AUC>0.6，说明尿微量白蛋白 /UCr诊断脂肪肝具有一定价值。结论尿酸、尿微量蛋白 /UCr、肥胖、脂质代谢紊乱、胰岛素抵抗与 T2DM病人非酒精性脂肪肝的发生相关，高尿微量蛋白 /UCr对于诊断 T2DM病人发生非酒精性脂肪肝具有一定价值。 |
| 英文摘要: |
| Objective To measure the levels of urinary microalbumin, urinary creatinine, blood lipid and serum total cholesterol inpatients with type 2 diabetes mellitus (T2DM), and to explore the effect of urinary microprotein / urinary creatinine ratio on nonalcoholicfatty liver in T2DM patients.Methods A hundred and twenty T2DM patients treated in The People's Hospital of Chizhou from June2018 to September 2019 were enrolled in the study. According to whether combined with fatty liver the patients were assigned into observation group (T2DM combined with non-alcoholic fatty liver) and control group (simple T2DM). There were 47 cases in the observationgroup and 73 cases in the control group. The blood indexes, blood biochemical indexes, urine micro-albumin, urine myostatin (UCr), triglyceride (TG), total serum cholesterol (TC) and urine micro-albumin/ UCr ratio were detected and compared between two groups. The relationship between blood lipid index and hyperuria microprotein / UCr ratio was analyzed by Pearson correlation. According to whetherthe patients were complicated with fatty liver (fatty liver = 1, without fatty liver = 0), the ROC curve of the diagnostic value of urinary microalbumin / UCr in fatty liver was drawn.Results The urinary microalbumin [45.48 (32.57,49.38) mg/L vs. 32.84 (25.68,36.34) mg/L] and urinary microalbumin / UCr [(56.42±10.35) mg/g vs. (37.57±9.28) mg/g], TG [(3.12±1.05) mmol/L vs. (2.05±1.84) mmol/L], TC [(6.28±2.35) mmol/L vs. (4.96±2.14) mmol/L], HOMA-IR [3.89 (1.86,4.29) vs. 2.74 (1.51,3.75)], HDL-C [(1.98±0.68) mmol/L vs. (0.96± 0.49) mmol/L], uric acid [(354.36±25.39) mmol/L vs. (249.63±26.14) mmol/L] in the observation group were significantly higher than those in the control group (P<0.05). Pearson correlation analysis results showed that TG, TC, HDL-C were positively correlated with high urinary micro-protein/ UCr ratio (r = 0.770, 0.694, 0.765, respectively; P <0.05). There was no correlation between LDL-C and high urinary microprotein / UCr (P > 0.05). The results of ROC curve showed that AUC was 0.892 with 95%CI (0.754-0.915). AUC > 0.6 indicated that urinary microalbumin / UCr had certain value in the diagnosis of fatty liver.Conclusion Uric acid, urinary microprotein/UCr,obesity, lipid metabolism disorder, insulin resistance are associated with the development of nonalcoholic fatty liver in T2DM patients.Hyperuria microprotein / UCr is of certain value in the diagnosis of nonalcoholic fatty liver in patients with T2DM. |
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