代谢综合征与2型糖尿病肾病危险因素的关系

目的:分析代谢综合征与2型糖尿病肾病危险因素之间的关系。方法:对607例2型糖尿病患者按是否合并糖尿病肾病和/或代谢综合征分成4组,并对其临床资料进行比较,用非条件Logistic回归法对糖尿病肾病的相关危险因素进行筛选。结果:糖尿病合并代谢综合征组(DM MS)收缩压、舒张压、体重指数(BMI)、腰围、血尿酸(UA)、甘油三脂(TG)、空腹血浆胰岛素、HOMA指数均高于未合并组(DM-MS)。糖尿病肾病合并代谢综合征组(DN MS)年龄、病程、糖化血红蛋白A1c(GHbA1c)、高密度脂蛋白胆固醇(HDL-c)均低于未合并代谢综合征组(DN-MS)。多因素分析结果表明,与糖尿病肾病发病相关的危险因素包括合并代谢综合征.、糖尿病病程、吸烟、收缩压、BMI、GHbA1c、TG、低密度脂蛋白胆固醇(LDL-c)及HOMA指数。结论:代谢综合征是2型糖尿病肾病发病的独立危险因素。代谢综合征的大多数组分均参与了糖尿病肾病的发病过程,且各因素之间相互影响。

The association between metabolic syndrome and the risk factors for diabetic nephropathy in type 2 diabetic patients

Objective:To investigate the association between metabolic syndrome and the risk factors for diabetic nephropathy in type 2 diabetic patients. Methods:607 type 2 diabetic patients were divided into 4 groups,based on whether complicated with diabetic nephropathy and/or metabolic syndrome,and their clinic data were analyzed.The risk factors for diabetic nephropathy were filtrated with logistic regression. Results: Systolic blood pressure,diastolic blood pressure,body mass index(BMI),waist circumference,fasting plasma uric acid,TG,insulin,HOMA index were higher in thos in DM+MS group than those in DM-MS group.Age,duration of diabetes,glycosylated HbA1c,HDL-c were lower in those in DN+MS than those in DN-MS group.With logistic regression analysis the followings were independent diabetic nephropathy risk factors: metabolic syndrome,duration of diabetes,smoking,systolic blood pressure,BMI,glycosylated HbA1c,TG,LDL-c and HOMA index. Conclusion: Metabolic syndrome is one of the independent diabetic nephropathy risk factors.Most of the component of the metabolic syndrome are joined in the development of diabetic nephropathy,and they interacted each other.