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投稿时间：2022-09-30 网络发布日期：2023-03-20
投稿时间：2022-09-30 网络发布日期：2023-03-20
中文摘要: 目的 对2型糖尿病（T2DM）患者血浆中低密度脂蛋白（LDL）不同亚型进行检测，分析其各亚型浓度水平与T2DM合并糖尿病肾病的关系。方法 选取2020年8月至2021年9月来南京江北医院就诊的T2DM患者共计174例，依据尿微量白蛋白/肌酐比值（UACR）分为无蛋白尿组（78例），微量蛋白尿组（54例），大量蛋白尿组（40例），另选取同期体检健康者38例为正常对照组。比较各组研究对象的一般资料、血清肌酐（Scr）、胱抑素C（Cys-C）、LDL、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）、尿液生化等实验室检测指标，计算BMI、小而密LDL（sdLDL）/LDL、估算肾小球滤过率（eGFR）等，分析LDL各亚型水平与T2DM合并糖尿病肾病患者肾脏功能损伤程度的相关性。结果 T2DM各亚组LDL亚型LDL-3、sdLDL、sdLDL/LDL、LDL、TC、Cys-C、eGFR明显高于对照组，HDL-C低于对照组，差异有统计学意义（P＜0.05）。在T2DM各亚组间比较，随着UACR的上升，LDL-4、LDL-5、sdLDL、sdLDL/LDL、LDL、eGFR水平依次升高，差异均有统计学意义（P＜0.05）。Logistic回归分析结果显示，LDL-3、LDL-4、LDL-5、sdLDL、sdLDL/LDL是UACR升高的影响因素（P＜0.05）。结论 T2DM患者血浆中LDL亚型检测LDL-3、LDL-4、LDL-5、sdLDL、sdLDL/LDL含量明显增多，随着UACR的上升逐渐升高。LDL-3、LDL-4、LDL-5、sdLDL以及sdLDL/LDL升高是T2DM患者合并糖尿病肾病发生发展的独立危险因素，有助于临床对T2DM患者糖尿病肾病的危险性评估。
中文关键词: 低密度脂蛋白亚型 小而密低密度脂蛋白 2型糖尿病 糖尿病肾病 尿微量白蛋白/尿肌酐比值
Abstract:Objective To detect the plasma low density lipoprotein (LDL) subtypes in patients with type 2 diabetes mellitus (T2DM) to analyze the relationship between the levels of LDL subtypes and T2DM complicated with diabetic nephropathy. Methods A total of 174 T2DM patients treated in Nanjing Jiangbei Hospital from August 2020 to September 2021 were recruited. According to the urinary microalbumin/creatinine ratio (UACR), the patients were divided into without proteinuria group (n=78), micro-proteinuria group (n=54) and macro-proteinuria group (n=40). In the same period,38 healthy people were served as controls. The following indicators were measured in each group, including the general clinical data, serum creatinine (Scr), cystatin C (Cys-C), LDL, high density lipoprotein cholesterol (HDL-C), total cholesterol (TC), urine biochemistry, BMI, small and dense low-density lipoprotein (sdLDL)/ LDL, estimated glomerular filtration rate (eGFR) to explore and analyze the associations of LDL subtypes levels with the degree of renal function impairment in T2DM patients with diabetic nephropathy. Results The LDL subtypes LDL-3, sdLDL, sdLDL/LDL, LDL, TC, Cys-C and eGFR in three T2DM subgroups were significantly higher than those in control group, and the HDL-C was statistically lower than that in control group (P＜0.05). With the increase of UACR, the levels of LDL-4, LDL-5, sdLDL, sdLDL/LDL, LDL and eGFR were statistically increased in T2DM subgroups (P＜0.05). Logistic regression analysis showed that LDL-3, LDL-4, LDL-5, sdLDL and sdLDL/LDL were the factors influencing the elevation of UACR (P＜0.05). Conclusion The elevated levels of LDL-3, LDL-4, LDL-5, sdLDL and sdLDL/LDL are the independent risk factors for the occurrence and development of T2DM patients with diabetes nephropathy, which is helpful for clinical risk assessment for these patients.
keywords: Low density lipoprote subtypes Small and dense low-density lipoprotein Type 2 diabetes mellitus Diabetic Nephropathy Urinary microalbumin/creatinine ratio
文章编号： 中图分类号：R587.1 文献标志码：B
基金项目:中国石化南化公司临床医学专项科研项目（ZX20203）
附件
| 作者 | 单位 |
| 陈久应1 | 1. 南通大学附属南京江北医院检验科，江苏 南京 210048 |
| 徐新润1 | 1. 南通大学附属南京江北医院检验科，江苏 南京 210048 |
| 宰国田2 | 2. 南通大学附属南京江北医院内分泌科，江苏 南京 210048 |
| 王玉蓉1 | 1. 南通大学附属南京江北医院检验科，江苏 南京 210048 |
引用文本：
陈久应,徐新润,宰国田,等.2型糖尿病患者血浆低密度脂蛋白亚型水平与糖尿病肾病的相关性[J].中国临床研究,2023,36(3):445-449.
陈久应,徐新润,宰国田,等.2型糖尿病患者血浆低密度脂蛋白亚型水平与糖尿病肾病的相关性[J].中国临床研究,2023,36(3):445-449.