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目的研究2型糖尿病患者(T2DM)尿白蛋白/肌酐比值(ACR)与铁代谢指标的相关性,为临床预测糖尿病微血管并发症发生提供参考依据。方法以2010年10月至2011年4月在本院内分泌科住院的64例T2DM患者为研究对象,其中男性34例,女性30例,年龄44~85岁,平均(64.4±12.5)岁,糖尿病病程2~30年,平均病程(13.6±6.7)年。根据研究对象入院24 h的ACR,分为正常蛋白尿组(ACR<30μg/mg)、微量蛋白尿组(ACR 30~300μg/mg)及大量蛋白尿组(ACR>300μg/mg),比较血清铁蛋白(SF)、血清铁离子(SI)等铁代谢指标的变化,及其与空腹血糖(FPG)、糖化血红蛋白(Hb A1C)和血尿酸(SUA)的关系。结果大量蛋白尿组SF水平[(399.44±70.57)μg/L]高于正常蛋白尿组和微量蛋白尿组[分别为(220.21±30.06)、(315.86±50.61)μg/L],而SI[(4.26±1.34)μmol/L]低于正常蛋白尿组和微量蛋白尿组[分别为(10.76±3.58)、(7.46±2.01)μmol/L],微量蛋白尿组SF水平高于正常蛋白尿组,而SI低于正常蛋白尿组,差异均有统计学意义(P<0.05),SF与SUA、Hb A1C、FPG呈正相关(r值分别为0.40、0.41和0.42,P<0.01),SI与SUA呈负相关(r=-0.39,P<0.01)。结论 SF、SI随尿白蛋白排泄量增加而改变,SF可以作为糖尿病微血管并发症的预测因子之一。
Objective To investigate the correlation between urinary albumin / creatinine ratio (ACR) and iron metabolism in type 2 diabetic patients (T2DM), and to provide a reference for the clinical prediction of the occurrence of diabetic microvascular complications. Methods Sixty-four patients with T2DM who were hospitalized in Department of Endocrinology in our hospital from October 2010 to April 2011 were enrolled in this study. There were 34 males and 30 females, aged 44-85 years, with an average of 64.4 ± 12.5 years. Diabetes mellitus Course of 2 to 30 years, the average duration (13.6 ± 6.7) years. According to ACR 24 h after admission, patients were divided into normal proteinuria group (ACR <30μg / mg), microalbuminuria group (ACR 30 ~ 300μg / mg) and large proteinuria group (ACR> 300μg / (SF), iron (SI) and other iron metabolism indicators, and its relationship with fasting blood glucose (FPG), HbAlc and serum uric acid (SUA). Results Compared with normal proteinuria group and microalbuminuria group, SF level in massive albuminuria group [(399.44 ± 70.57) μg / L] was (220.21 ± 30.06) and (315.86 ± 50.61) μg / L, (4.26 ± 1.34) μmol / L] were lower than those in normal albuminuria group and microalbuminuria group [(10.76 ± 3.58) and (7.46 ± 2.01) μmol / L, respectively] (P <0.05). There was a positive correlation between SF and SUA, Hb A1C and FPG (r = 0.40, 0.41 and 0.42, respectively, P <0.01) And SUA was negatively correlated (r = -0.39, P <0.01). Conclusions SF and SI change with the increase of urinary albumin excretion. SF can be used as one of the predictors of diabetic microvascular complications.