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| 糖尿病肾脏病患者尿白蛋白排泄率与骨代谢生化指标相关性分析 |
| A correlation analysis of urinary albumin excretion rate and biochemical markers of bone metabolism in patients with type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1006.7108.2017.12.012 |
| 中文关键词: 2型糖尿病 尿白蛋白排泄率 骨代谢生化指标 |
| 英文关键词:Type 2 diabetes mellitus Urinary albumin excretion rate Biochemical markers of bone metabolism |
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| 中文摘要: |
| 目的 分析2型糖尿病患者尿白蛋白排泄率与骨代谢生化指标的相关性。方法 选取2013年10月至2015年6月于重庆医科大学附属第一医院内分泌科住院的2型糖尿病患者302名。搜集其基本资料、骨代谢生化指标及骨密度等。按尿白蛋白排泄率(urinary albumin excretion rate，UAER)的水平将其分为正常白蛋白尿组(132名)、微量白蛋白尿组(101名)、大量白蛋白尿组(69名)。并作统计学分析。结果 三组间骨密度（bone mineral density，BMD)比较差异无统计学意义，2型糖尿病患者25(OH)D3、1型前胶原氨基末端前肽（type I procollagen N-terminal propeptide，P1NP）在大量白蛋白尿组显著低于微量白蛋白尿组、正常白蛋白尿组（P<0.05）；随着UAER的升高，1型胶原羧基端肽β特殊序列（β-Carboxyl terminal peptide，β-CTX）逐渐升高、骨钙素(bone alkaline phosphatase，BGP)逐渐降低，大量白蛋白尿组、微量白蛋白尿组与正常白蛋白尿组比较差异有统计学意义(P<0.05)。Spearman等级相关分析示P1NP、BGP、25(OH)D3与UAER呈负相关，β-CTX与UAER呈正相关。结论 糖尿病肾脏病患者骨代谢生化指标的改变可能早于骨密度反映骨代谢异常。 |
| 英文摘要: |
| Objective To investigate the association of urinary albumin excretion rate and biochemical markers of bone metabolism in patients with type 2 diabetes. Methods A retrospective analysis was made in 302 cases of patients with type 2 diabetes mellitus, who were admitted to the Department of Endocrinology of the 1st Affiliated Hospital of Chongqing Medical University from Oct 2013 to Jun 2015. According to the stage of UAER, the patients were divided into three groups: normal albuminuria group (132 cases), microalbuminuria group (101 cases) and macroalbuminuria group (69 cases). Data of general clinical information, biochemical markers monitoring of bone metabolism and bone mineral density etc. were analyzed to evaluate the correlation between urinary albumin excretion rate and biochemical markers of bone metabolism. Results There were no significant differences in BMD among the three groups. The levels of 25(OH)D3 and P1NP in the macroalbuminuria group was the lowest compared with the microalbuminuria group and the normal albuminuria group, and the differences were statistically significant (P<0.05). Compared with the normal albuminuria group, the level of β-CTX significantly increased and the level of BGP decreased in the macroalbuminuria group and the microalbuminuria group, and the differences were statistically significant (P<0. 05). Spearman correlation analysis showed that P1NP, BGP and 25(OH)D3 were negatively correlated with UAER and that β-CTX was positively correlated with UAER. Conclusion Biochemical markers of bone metabolism in diabetic kidney disease may reflect abnormal bone metabolism earlier than BMD. |
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