2型糖尿病患者预估肾小球滤过率与血清胆红素的相关性

目的 研究2型糖尿病患者预估肾小球滤过率（eGFR）与血清总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）的相关性.方法 选取2011年11月至2012年9月于天津医科大学代谢病医院糖尿病肾病科住院治疗的2型糖尿病患者523例为研究对象,按eGFR分为肾小球高滤过组（133例）、肾功能正常组（194例）、肾功能轻度下降组（125例）、肾功能中重度下降组（71例）.比较各组TBIL、DBIL、IBIL水平,并行相关因素分析,多组计量资料间比较采用方差分析.结果 肾小球高滤过组各胆红素水平较肾功能正常组水平均明显下降分别为TBIL：（10.9±4.0）比（12.5 ±4.5）μmol/L、DBIL：（3.8±1.6）比（4.4±1.7） μmol/L、IBIL：（7.1 ±2.8）比（8.0±3.1）μmol/L,均P＜0.05].肾功能中重度下降组TBIL、DBIL、IBIL水平较其他3组均明显下降（F=15.296、15.024、11.609,均P＜0.05）.在eGFR＜ 130 ml/min的人群中,eGFR的相关分析结果提示：eGFR与年龄、病程、总胆固醇、低密度脂蛋白胆固醇呈负相关（r=-0.307、-0.203、-0.149、-0.111,均P＜0.05）,与TBIL、DBIL、IBIL呈正相关（r=0.291、0.275、0.254,均P＜0.05）.结论 2型糖尿病患者血清胆红素水平与肾小球滤过率相关.

Correlation of glomerular filtration rate and serum bilirubin in patients with type 2 diabetes mellitus

Objective To investigate the correlation between glomerular filtration rate （estimated glomerular filtration rate,eGFR） and serum total bilirubin （TBIL）,direct bilirubin （DBIL）,indirect bilirubin（IBIL） in patients with type 2 diabetes mellitus.Methods According to eGFR levcl,523 cases of type 2 diabetic inpatients from October 2011 to September 2012 in Department of Diabetic Nephropathy,Metabolic Diseases Hospital,Tianjin Medical University were divided into four groups：glomerular hyperfiltration group （n =133）,normal renal function group （n =194）,mild renal dysfunction group （n =125）,moderate and severe renal dysfunction group （n =171）.The differences of TBIL,DBIL and IBIL levels among the four groups were compared.The related factors analysis of eGFR was perfor,med.Variance analysis was used to analysize mulitiple groups of data.Results The bilirubin levels of glomerular hyperfiltration group was significantly lower than normal renal function group （P ＜ 0.05）.TBIL level was （10.9 ±4.0） vs （12.5 ±4.5） μmol/L,DBIL level was （3.8 ± 1.6） vs （4.4 ± 1.7） μmol/L,IBIL level was （7.1 ± 2.8） vs （8.0 ± 3.1） μ mol/L.The levels of TBIL,DBIL and IBIL in moderate and severe renal dysfunction group significantly reduced than those of other three groups （F =15.296,15.024,11.609,all P＜ 0.05）.In the patients with eGFR ＜ 130 ml/min,correlation analysis results indicate：eGFR was negatively correlated with age,the course of diabetes,total cholesterol,low-density lipoprotein cholesterol （r =-0.307,-0.203,-0.149,-0.111,all P ＜ 0.05）,and was positively correlated with TBIL,DBIL and IBIL （r =0.291,0.275,0.254,all P ＜ 0.05）.Conclusion Serum bilirubin levels are associated with glomerular filtration rate in patients with type 2 diabetes.