Correlation between residual cholesterol and urinary albumin-to-creatinine ratio in patients with type 2 diabetes mellitus
赵伟文 1高明 2王雪鹰2
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作者信息
1. 锦州医科大学丹东市中心医院研究生培养基地,辽宁 118000
2. 锦州市中心医院内分泌科
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摘要
目的 探讨2型糖尿病患者残余胆固醇(remnant cholesterol,RC)与尿白蛋白肌酐比值(urine albumin-to-creatinine ratio,UACR)的相关性.方法 选取2020年3月至2022年5月于丹东市中心医院内分泌科住院的165例2型糖尿病患者作为研究对象,根据UACR水平将其分成正常白蛋白尿组(A组55例,UACR<30 mg/g)、微量白蛋白尿组(B组55例,UACR30～300 mg/g)、大量白蛋白尿组(C组55例,UACR>300 mg/g).收集研究对象的一般信息、血脂、尿白蛋白和肌酐等,计算RC和UACR,比较各组间指标的差异,对RC与UACR进行相关性分析.2型糖尿病合并糖尿病肾病(diabetic kidney disease,DKD)的影响因素采用多因素logistic回归分析;绘制受试者工作特征曲线并计算曲线下面积(area under the curve,AUC)评估RC的诊断价值.结果 C组RC水平显著高于A组、B组,B组RC水平高于A组,差异有统计学意义(P<0.05).RC与UACR成正相关(r=0.162,P<0.01).多元logistic回归分析结果显示,糖尿病病程、RC、年龄、收缩压和总胆固醇是DKD的独立危险因素(P<0.05).RC对诊断2型糖尿病患者发生DKD有一定的价值(AUC=0.74,95%CI0.66～0.81,P<0.05),进一步将RC与年龄联合分析发现,诊断价值更高(AUC=0.86,95%CI 0.80～0.92).结论 2型糖尿病患者RC水平与UACR相关,RC可能成为预测2型糖尿病患者发生DKD新的标志物.
Abstract
Objective To determine the correlation between residual cholesterol(RC)and urinary albumin-to-creatinine ratio(UACR)in type 2 diabetes patients.Methods One hundred sixty-five patients with type 2 diabetes who were hospitalized in the Endocrinology Department of Dandong Central Hospital from March 2020 to May 2022 were selected and divided into the following groups based on UACR:normal albumin-uria(group A,55 patients,UACR<30 mg/g);micro-albuminuria(group B,55 patients,UACR 30-300 mg/g);and severe albuminuria groups(group C,55 patients,UACR>300 mg/g).General demo-graphic data,and blood lipid,urinary albumin,and creatinine levels of the study subjects were collected,the RC and UACR were calculated,the differences between the groups were compared,and a correlation analysis between the RC and UACR was performed.Multivariate logistic regression analysis was used to analyze the influencing factors among type 2 diabetes patients with diabetic kidney disease.A receive operating char-acteristic(ROC)curve of the subjects was created and the area under the ROC curve(AUC)was used to evaluate the diagnostic value of the RC.Results The RC of group C was significantly higher than groups A and B,and the RC of group B was higher than group A(P<0.05).The RC was positively correlated with the UACR(r=0.162,P<0.01).Multivariate logistic regression analysis showed that the course of dia-betes,RC level,age,systolic blood pressure,and total cholesterol level were shown to be independent risk factors for diabetic kidney disease(P<0.05).Indeed,the RC level had clinical value in the diagnosis of type 2 diabetes patients with diabetic kidney disease(AUC=0.74,95％CI:0.66-0.81,P<0.05),which was further increased by a combined analysis of the RC level and age(AUC=0.86,95％CI:0.80-0.92).Conclusions The RC level in type 2 diabetes patients is related to the UACR.RC may serve as a new marker for predicting diabetic kidney disease in type 2 diabetes patients.
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