·糖尿病大血管病变·

　　2型糖尿病患者微量白蛋白尿与大血管病变的相关性研究

　　韩佳琳 董砚虎 马山英 孙士杰 陈月华 王娜

　　【摘要】 目的 探讨T2DM患者微量白蛋白尿与无临床症状大血管病变的相关关系。 方法 选取在我院住院和门诊随访的资料完整的糖尿病患者190例(DM组)，正常对照组22名(NC组)。所有研究对象进行人体学测量，生化指标测定及胰岛素释放试验以及血管彩超检查，颈总动脉内中膜厚度(CIMT)和下肢动脉内径等。应用稳态模型评估法(HOMA)及李光伟指数(IAI)评价IR。 结果 CIMT与下肢各动脉内径均呈显著负相关。CIMT及下肢动脉内径与年龄、病程、SBP、DBP、TG、TC、LDL-C、HbA1c、MAU、HOMA-IR呈显著正相关，与HDL-C、IAI呈显著负相关，与BMI无相关性。 结论 T2DM伴微量白蛋白尿患者同时存在早期大血管病变，而且尿微量白蛋白排泄率越高，早期大血管病变越重。IR可能是T2DM患者微量白蛋白尿和早期大血管病变的共同患病基础。

　　【关键词】糖尿病，2型;微量白蛋白尿;大血管病变

　　Correlation between microalbunminuria and macroangiopathy in T2DM patients HAN Jia-lin, DONG Yan-hu, MA Shan-ying, et al. Qingdao Endocrine & Diabetes Hospital, Qingdao 266071, China

　　【Abstract】 Objective To investigate the correlation between microalbuminuria and macroangiopathy in T2DM patients without clinical symptoms. Methods One hundred and ninety in- and out-patients with diabetes of our hospital with complete data (DM group) and 22 healthy subjects (control group) were involved in this trial. All subjects had oral glucose tolerance test (OGTT), insulin release test, and vascular ultrasonography, and were measured height, weight, blood pressure, blood lipids, hemoglobin A1c, microalbuminuria, carotid intima thickness (CIMT), and lower limb artery internal diameter. Homeostasis model assessment (HOMA) and Li Guangwei’s Index (IAI) were used to evaluate insulin resistance (IR). Results CIMT was negatively related to internal diameter of lower limb’s arteries (r=-0.547, r=-0.594, r=-0.463, P<0.01). CIMT and internal diameter of lower limb’s arteries were positively related to age, course of disease, SBP, DBP, TG, TC, LDL-C, HbA1C, MAU, and HOMA-IR, while negatively related to HDL-C and IAI (P<0.01), but without relation to BMI (P=0.526). Conclusion T2DM associated with microalbuminuria have macroangiopathy in the early stage of diabetes. The more albuminuria is, the severe macroangiopathy will be. Insulin resistance may be the common basis in appearance of microalbuminuria and macroangiopathy.

　　【Key words】 Diabetes mellitus, type2; Microalbuminuria; Macroangiopathy