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目的:探讨2型糖尿病患者尿白蛋白排泄与胰岛素抵抗和血脂的关系以及胰岛素抵抗在糖尿病肾病(DN)中发生的作用。方法:将80例2型糖尿病患者按尿白蛋白排泄率(UAER)分为正常蛋白尿组和微量白蛋白尿组,对血糖、胰岛素、胰岛素敏感指数(1SI)、血脂、血尿酸、纤维蛋白原、糖化血红蛋白、肌酐等代谢指标进行比较分析,并对UAER与相关因素进行多元回归分析。结果:两组间ISI、甘油三酯、尿酸、高密度脂蛋白水平存在显著性差异(P <0 .0 5或P <0 .0 1 ) ;Persean相关显示UAER与ISI、甘油三酯、低密度脂蛋白、尿酸、糖化血红蛋白、年龄相关;在以UAER为自变量的线性多元回归分析中显示在P <0 . 0 5水平有ISI、甘油三酯、低密度脂蛋白和肌酐进入回归模型。结论:在2型糖尿病患者合并白蛋白尿时存在胰岛素敏感性减低和脂代谢紊乱,胰岛素抵抗和脂代谢紊乱对MAU的产生有重要作用。
Objective: To investigate the relationship between urinary albumin excretion and insulin resistance and blood lipids in type 2 diabetic patients and the role of insulin resistance in diabetic nephropathy (DN). Methods: Eighty patients with type 2 diabetes mellitus were divided into normal proteinuria group and microalbuminuria group according to urinary albumin excretion rate (UAER). The levels of blood glucose, insulin, insulin sensitivity index (1SI), blood lipid, serum uric acid, fibrin The original, glycosylated hemoglobin, creatinine and other metabolic indicators for comparative analysis, and UAER and related factors by multiple regression analysis. Results: The levels of ISI, triglyceride, uric acid and high density lipoprotein were significantly different between the two groups (P <0.05 or P <0.01). Persean correlation showed that UAER and ISI, triglyceride, low In the linear multiple regression analysis with UAER as an independent variable, it showed that ISI, triglyceride, LDL and creatinine were involved in the regression model at P <0.05 level. CONCLUSION: In patients with type 2 diabetes mellitus, albuminuria is associated with reduced insulin sensitivity and dyslipidemia, and insulin resistance and dyslipidemia may play an important role in MAU production.