红细胞分布宽度与老年糖尿病肾病患者肾小球滤过率的相关性

Correlation between Red Blood Cell Distribution Width and Glomerular Filtration Rate in the Elderly with Diabetic Nephropathy

中文关键词: 红细胞分布宽度  糖尿病肾病  尿白蛋白/肌酐  肾小球滤过率

英文关键词: red blood cell distribution width (RDW)  diabetic nephropathy  ratio of albumin/creatinine (ACR)  glomerular filtration rate (GFR)

中文摘要:

      目的 研究红细胞分布宽度(RDW-SD)与老年糖尿病肾病患者肾小球滤过率的相关性.方法 将264例2型老年糖尿病患者分为单纯糖尿病(DM)组164例、早期糖尿病肾病(EDN)组60例和临床糖尿病肾病(CDN)组40例,选择正常对照组60例.分别测定血清肌酐(Cr)、空腹血糖(FBG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、血尿酸(UA)、谷丙转氨酶(ALT),高敏C反应蛋白(Hs-CRP)、糖化血红蛋白(HbAlc)、血浆红细胞分布宽度(RDW-SD)、铁蛋白(SF)、尿白蛋白/肌酐比值(ACR)、肾小球滤过滤(eGFR)等指标,对各组RDW-SD水平的变化情况及与相应指标间的关系进行统计分析.结果 糖尿病各组RDW-SD水平高于对照组[(38.8±5.8) fl vs (35.1±5.4) fl,P＜0.05],且随着eGFR水平的降低RDW-SD水平升高(P＜0.05),EDN组R DW-SD水平与HbA1c、eGFR水平呈负相关(P＜0.05),与糖尿病病程、HbA1c、FBG、TC、TG、HDL-C、UA、Cr、ACR、Hs-CRP、SF呈正相关(P＜0.05);多元逐步回归分析显示,糖尿病病程、HbA1c、RDW-SD和ACR是eGFR的独立危险因素(P＜0.05).结论 RDW-SD增加时eGFR降低,两者有相关性RDW-SD有可能作为糖尿病肾脏病的一个早期检测指标.

英文摘要:

      Objective To explore the correlation between red blood cell distribution width (RDW) and glomerular filtration rate (GFR) in the elderly with diabetic nephropathy.Methods 264 elderly patients with type 2 diabetes were divided into 3 groups:simple diabetes mellitus group (MD group) (n=164),early diabetic nephropathy (EDN group) (n=60) and clinical diabetic nephropathy group (CDN group) (n=40),and 60 norm were selected to be control group;detections were made to serum creatinine (Cr),fasting blood glucose (FBG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),uric acid (UA),alanine aminotransferase (ALT),sensitive-C-reactive protein (Hs-CRP),glycatedhemoglobin (HbA1c),RDW,serum ferritin (SF),ratio of albumin/creatinine (ACR) and eGRF and statistical analysis was made to the changes of RDW in each group and to the correlation among the related index.Results The levels of RDW in each of the diabetes groups were higher than that in control group [(38.8±5.8) fl vs (35.1±5.4) fl,P＜0.05],and the level of RDW kept increasing with the decreasing of eGFR (P＜0.05);in EDN group,the level of RDW was in negative correlation with the levels of HbAlc and eGFR (P＜0.05)while in positive correlation with diabetes duration and the levels of HbA1c,FBG,TC,TG,HDL-C,UA,Cr,ACR and Hs-CRP (P＜0.05);multiple stepwise regression analysis indicated that diabetes duration,HbA1c,RDW and ACR were the independent risk factors of eGFR (P＜0.05).Conclusions eGFR decreases when RDW increases,there exists certain correlation between them;RDW may be taken as an early diagnosing biomarker of diabetic nephropathy.