·糖尿病慢性肾脏疾病·

　　【摘要】 目的 探讨糖尿病慢性肾脏疾病(CKD)患者皮肤晚期糖基化终末产物(AGEs)水平变化及其临床意义。方法 将96例T2DM患者按尿白蛋白/尿肌酐比值(UACR)分为正常白蛋白尿(NCKD)组、微量白蛋白尿(CKD1)组和大量白蛋白尿(CKD2)组，另选健康对照(NC)组32名，分别测定皮肤AGEs、HbA1c、UACR等指标。结果 与NC组相比，T2DM患者皮肤AGEs水平升高(P<0.01);与NCKD组相比，CKD组皮肤AGEs水平升高(P<0.05)，且CKD2组皮肤AGEs水平高于CKD1组(P<0.05)。多元逐步回归分析显示，年龄及糖尿病病程是皮肤AGEs的独立相关因素。Logistic回归分析结果表明，皮肤AGEs水平与血压是CKD的独立相关因素(P<0.05)。结论 皮肤AGEs水平可能参与了CKD发病，可将其作为监测CKD发生、评估CKD程度的一个指标。

　　【关键词】糖尿病慢性肾脏疾病;糖尿病，2型;晚期糖基化终末产物

Correlation between the skin advanced glycation end products and chronic kidney disease in diabetes YE Cheng-song,YE Shan-dong, WANG Yi-kun. Department of Endocrinology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China

　　【Abstract】Objective To explore the changes in the level and clinical significance of skin advanced glycation end products(AGEs) in the chronic kidney disease (CKD) of T2DM patients. Methods According to the urinary albumin/creatinine ratio (UACR), 96 T2DM patients were divided into three groups: normal albuminuria (NCKD) group, micro-albuminuria (CKD1) group, macro-albuminuria (CKD2) group. And 32 healthy people were selected from the medical center and put into the normal control (NC) group. The levels of skin AGEs, HbA1c, UACR, etc. were detected for study. Results Compared with the NC group, the level of skin AGEs was obviously increased in T2DM patients.Compared with the NCKD group,the level of skin AGEs was increased in the CKD group (P<0.05), and the level of skin AGEs in the CKD2 group was higher than in the CKD1 group (P<0.05). A multiple stepwise regression analysis indicated that age and duration of diabetes were independent factors affecting skin AGEs. Multivariate logistic regression analysis showed that skin AGEs and blood pressure were significant risk factors of CKD in diabetes. Conclusion AGEs may be involved in the pathogenesis of CKD in diabetes. It can be used as an index for monitoring the development of CKD in diabetes and evaluating its severity.

　　【Key Words】Chronic kidney disease (CKD) in diabetes; Diabetes mellitus, type 2; Advanced glycation end products (AGEs)