·糖尿病性肾脏疾病·

　　【摘要】 目的 探讨糖尿病慢性肾脏疾病(CKD)患者血清瘦素(Lep)和血脂水平的变化及其临床意义。 方法 根据UAER水平将120例T2DM患者分为<30 mg/24 h组41例、30～299 mg/24 h组44例和≥300 mg/24 h组35例，另选取健康志愿者40名作为对照(NC)组。检测FPG、HbA1c、Lep及血脂各项。 结果 CKD各组FPG、HbA1c、Lep、TG、TC、LDL-C水平均高于NC组，HDL-C低于NC组(P<0.05)。30～299 mg/24 h组和≥300 mg/24 h组FPG、HbA1c、Lep、TC、TG、LDL-C水平高于<30 mg/24 h组， HDL-C低于<30 mg/24 h组，且≥300 mg/24 h组高于30～299 mg/24 h组(P<0.05)。Lep水平与UAER呈正相关(P<0.01)。 结论 CKD患者HbA1c、Lep、血脂水平均升高，且与微血管病变程度有关，提示 HbA1c、Lep、血脂水平可预测CKD的进展。

　　【关键词】 糖尿病慢性肾脏疾病;糖化血红蛋白;瘦素;血脂

　　Study of the level of serum leptin and lipid in type 2 diabetes patients with chronic kidney disease WANG Ying，ZHU Tie-hong，TONG Jun-wang，et al. Department of Endocrinology，Tianjin Medical University General Hospital，Tianjin 300052，China

　　Corresponding author：ZHU Tie-hong，E-mail：zhutiehong@163.com

　　【Abstract】 Objective To explore the changes of serum leptin and lipid levels in type 2 diabetes patients with chronic kidney disease (CKD) and its clinical significance. Methods 120 cases with T2DM were divided into <30 mg/24 h group(n=41)，30～299 mg/24 h group(n=44) and ≥300 mg/24 h group(n=35) according to the UAER.40 healthy volunteers were selected as normal control (NC) group.FPG，HbA1c，serum leptin and lipid were measured. Results In the early stage of diabetic nephropathy group and middle—late stage group，The levels of FPG，HbA1c，Leptin，TG，TC and LDL-C were higher，and HDL-C was lower in different CKD groups than in NC group (P<0.05).The levels of FPG，HbA1c，leptin，TC，TG LDL-C were higher，and HDL-C was lower in 30～299 mg/24 h group and ≥300 mg/24 h group than in <30 mg/24 h group，moreover those indexes were higher in ≥300 mg/24 h group than in 30～299 mg/24 h group (P<0.05). Leptin level was positively correlated with UAER(P<0.01). Conclusion HbA1c，leptin and lipid level is increased in CKD patients，and correlated with the degrees of microvascular disease. The levels of HbA1c，leptin，blood lipid levels can predict the progress of CKD.

　　【Key words】 Chronic kidney disease(CKD) in diabetes;Leptin;Serum lipid