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目的探讨2型糖尿病(T2DM)合并高乳酸血症状态下机体脂代谢水平、肾功能、肾小球滤过率(GFR)、肌酐清除率(Ccr)、尿微量白蛋白(M-ALB)等变化。方法选取2型糖尿病患者100例,将其分为2型糖尿病高乳酸组和2型糖尿病乳酸正常组,测定所有研究对象的身高(H)、体重(W)、体重指数(BMI)、腰围(WC)、臀围(HC)、腰身比(WSR)、腰臀比(WHR)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、肌酐(CR)、尿素氮(BUN)、肾小球滤过率(GFR)、肌酐清除率(Ccr)、24h尿微量白蛋白等临床资料及生化指标。结果 1糖尿病高乳酸组患者CR,TG,WSR,24h尿微量白蛋白水平明显高于糖尿病乳酸正常组(P<0.05),而GFR,Ccr低于糖尿病乳酸正常组(P<0.05),两组BMI,WC,HC,WHR,FPG,Hb A1c,TC,LDL,BUN等无明显统计学差异(P>0.05)。2应用Pearson相关性分析提示:血乳酸水平与Cr(r=0.354,P<0.001)呈正相关,与HDL(r=-0.260,P<0.05)、GFR(r=-0.287,P<0.05)及Ccr(r=-0.205,P<0.05)呈负相关。结论高血乳酸可能为糖尿病脂代谢紊乱及糖尿病肾脏病的潜在危险因素,对于2型糖尿病患者而言,早期监测血乳酸水平及积极防治高乳酸血症对于纠正脂代谢紊乱、延缓肾功能恶化具有重要意义。
Objective To investigate the relationship between body fat metabolism, renal function, glomerular filtration rate (GFR), creatinine clearance (Ccr), urine microalbumin (M-ALB) and so on in type 2 diabetes mellitus (T2DM) Variety. Methods 100 patients with type 2 diabetes mellitus were selected and divided into two groups: type 2 diabetes mellitus with high lactate and type 2 diabetes mellitus with normal lactic acid. All subjects were measured for height (H), body weight (W), body mass index (BMI), waist circumference WC, Hips, WSR, WHR, FPG, Hb A1c, TC, TG, low density lipoprotein The clinical data of LDL, HDL, CR, BUN, GFR, Ccr and 24h urinary albumin Biochemical Indicators. Results The levels of CR, TG, WSR and 24h urine microalbuminuria in diabetic patients with high lactate were significantly higher than those with normal lactate (P <0.05), but GFR and Ccr were lower than those with normal lactate (P <0.05) BMI, WC, HC, WHR, FPG, Hb A1c, TC, LDL, BUN and other no significant difference (P> 0.05). (2) Pearson correlation analysis suggested that the level of serum lactate was positively correlated with Cr (r = 0.354, P <0.001) Ccr (r = -0.205, P <0.05) was negatively correlated. Conclusions Hyperglycemic lactic acid may be a potential risk factor for diabetic lipid disorders and diabetic nephropathy. In type 2 diabetic patients, early monitoring of blood lactate levels and active prevention and treatment of hyperlacticic acid may be helpful to correct lipid disorders and delay renal dysfunction Significance.