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目的:探讨2型糖尿病(T2DM)患者伴发肾结石的临床特征及危险因素。方法:选取T2DM伴肾结石患者48例设为观察组,同时选取T2DM不伴发肾结石患者48例为对照组,检测两组患者糖化血红蛋白(Hb A1c)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、空腹胰岛素(FINS)、餐后2 h血糖(2 h PBG)、空腹血糖(FBG)、尿p H值等指标。结果:观察组TG、FINS、LDL-C和胰岛素抵抗指数(HOMA-IR)明显高于对照组,而尿p H值和HDL-C明显低于对照组,差异有统计学意义(P<0.05);非条件Logistic分析结果显示尿p H值、HOMA-IR是T2DM伴肾结石发生的独立危险因素,其中尿p H值的OR值最高。结论:胰岛素抵抗、脂代谢紊乱以及尿p H值在T2DM伴肾结石疾病发生过程中有重要作用,其中尿p H值、HOMA-IR是T2DM伴肾结石的独立危险因素。
Objective: To investigate the clinical characteristics and risk factors of type 2 diabetes mellitus (T2DM) associated with kidney stones. Methods: Forty-eight patients with T2DM and nephrolithiasis were enrolled as the observation group. Forty-eight patients with T2DM without nephrolithiasis were selected as the control group. Hb A1c, triglyceride (TG), low density (HDL-C), total cholesterol (TC), fasting insulin (FINS), 2 h postprandial blood glucose (2 h PBG), fasting blood glucose (FBG) p H value and other indicators. Results: The levels of TG, FINS, LDL-C and HOMA-IR in the observation group were significantly higher than those in the control group, but the urinary p H and HDL-C levels in the observation group were significantly lower than those in the control group (P <0.05 ). Logistic analysis showed that urine p H value and HOMA-IR were independent risk factors for T2DM with renal calculi, and urinary p H value had the highest OR value. CONCLUSION: Insulin resistance, dyslipidemia and urinary p H values play an important role in the pathogenesis of T2DM with nephrolithiasis. Urinary p H values and HOMA-IR are independent risk factors for T2DM with renal stones.