摘要
目的 探讨住院的初诊2型糖尿病(T2DM)患者血清载脂蛋白A1(ApoA1)水平与糖尿病肾脏病(DKD)风险之间的相关性.方法 为横断面研究.选择2018年1月至2022年5月在徐州医科大学附属徐州市立医院内分泌科住院的670例初诊T2DM患者作为研究对象.收集患者的年龄、性别、吸烟情况、饮酒情况、糖尿病病程、体重指数(BMI)、既往病史、既往用药史、糖尿病并发症情况,以及实验室指标,包括ApoA1、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白a(LPa)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、估算的肾小球滤过率(eGFR)、尿白蛋白/肌酐比值(UACR).根据有无DKD将患者分为DKD组(233例)和非DKD组(437例).组间比较采用t检验、秩和检验和x2检验.采用多因素logistic回归分析法评估血清ApoA1水平与DKD风险之间的关系.结果 与非DKD组相比,DKD组的血清ApoA1水平明显降低[分别为(1.36±0.40)和(1.53±0.35)g/L,t=5.22,P＜0.010].多因素logistic回归分析结果显示,在校正年龄、性别、吸烟、饮酒、糖尿病病程、BMI、高血压、降压药使用情况、TG、TC、LDL-C、HDL-C、LPa、ApoB、ApoE、FPG、HbA1c、eGFR、UACR 后,血清 ApoA1 水平与 DKD 风险有关(OR=0.24,P=0.010).结论 在初诊T2DM患者中,伴DKD者的血清ApoA1水平较不伴DKD者显著降低,血清ApoA 1水平与DKD风险有关.
Abstract
Objective To investigate the association between serum apolipoprotein A1(ApoA1)levels and the risk of diabetic kidney disease(DKD)in hospitalized patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods This cross-sectional study included 670 newly diagnosed T2DM patients who were hospitalized at the Department of Endocrinology of Xuzhou Municipal Hospital,affiliated to Xuzhou Medical University from January 2018 to May 2022.Patient data including age,sex,smoking,alcohol consumption,duration of diabetes mellitus,body mass index(BMI),previous medical history,previous medication history,diabetes complications,ApoA1,triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein a(LPa),apolipoprotein B(ApoB),apolipoprotein E(ApoE),fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),estimated glomerular filtration rate(eGFR),and urinary albumin-to-creatinine ratio(UACR)were collected.Patients were categorized into DKD(233 patients)and non-DKD(437 patients)groups according to the presence or absence of DKD.The t test,rank sum test and x2 test were used for between-group comparisons of quantitative and qualitative variables,respectively.The correlation between serum ApoA1 levels and DKD risk was assessed by multivariate logistic regression.Results Serum ApoA1 levels were significantly lower in the DKD group when compared to the non-DKD group[(1.36± 0.40)vs.(1.53±0.35)g/L,respectively,t=5.22,P＜0.010].After adjusting for age,sex,smoking,alcohol consumption,duration of diabetes,BMI,hypertension,antihypertensive medication,TG,TC,LDL-C,HDL-C,LPa,ApoB,ApoE,FPG,HbA1c,eGFR,and UACR,a significant correlation was found between the serum ApoA1 level and the risk of DKD in logistic regression(OR=0.24,P=0.010).Conclusions Among newly diagnosed T2DM patients,serum ApoA1 levels were significantly lower in those with DKD than in those without DKD,and serum ApoA1 levels were significantly and negatively associated with the risk of DKD.
基金项目
徐州市重点研发计划(社会发展)-医药卫生面上项目(KC22141)
维普
万方数据