合并胃肠功能紊乱的老年糖尿病肾病患者的临床特征

Clinical characteristics of elderly patients with diabetic nephropathy complicated with gastrointestinal dysfunction

中文关键词: 老年  糖尿病肾病  胃肠功能紊乱  肾功能  胃肠激素  临床特征  列线图模型

英文关键词: elderly  diabetic nephropathy  gastrointestinal dysfunction  renal function  gastrointestinal hormone  clini-cal characteristics  nomogram model

中文摘要:

      目的 探讨合并胃肠功能紊乱(GD)的糖尿病肾病(DN)患者的临床特征.方法 回顾性分析2021年3月-2023年9月成都西区医院就诊的DN患者205例,分为观察组(98例,合并GD)和对照组(107例).比较2组基线资料、肾功能指标值及胃肠激素水平;利用Pearson相关性分析和多因素Logistic回归分析方法探讨肾功能与胃肠激素之间的关系;构建列线图模型预测GD的发生风险,并通过受试者工作特征(ROC)校准曲线对模型进行验证.结果 2组性别、年龄差异均无统计学意义(P＞0.05);观察组BP、FBG、HbA1c值平均高于对照组(P＜0.05);观察组BUN水平、Scr水平、UAER值均高于对照组(P＜0.05),而eGFR值低于对照组(P＜0.05);观察组血清胃泌素、胰高血糖素、GIP、CCK水平升高(P＜0.05).Pearson相关性分析表明,胃泌素、胰高血糖素、GIP、CCK水平与BUN水平、Scr水平、UAER值呈正相关(r＞0,P＜0.05),与eGFR值呈负相关(r＜0,P＜0.05).多因素Logistic回归分析表明,高BUN水平、高Scr水平、高UAER值、低eGFR值及高胃泌素、高GIP、高CCK水平是DN患者发生GD的影响因素(P＜0.05).列线图模型的AUC为0.977.结论 DN合并GD的老年患者可能表现出更为严重的肾功能损害和异常的胃肠激素水平.

英文摘要:

      Objective To explore the clinical characteristics of patients with diabetic nephropathy(DN)complicated with gastrointestinal dysfunction(GD).Methods A retrospective analysis was conducted on 205 patients with DN who visited Chengdu West District Hospital from March 2021 to September 2023.They were divided into observation group(98 cases,combined with GD)and control group(107 cases).The baseline data,renal function indicators and gastrointestinal hormone levels of the two groups were compared.Pearson correlation analysis and multivariate Logistic regression analysis was used to determine the relationship between renal function and gastrointestinal hormones.A nomogram model was constructed to predict the risk of GD occurrence,and the model was verified through the receiver operating characteristic(ROC)calibration curve.Results There was no statistically significant difference in gender and age between the two groups(P＞0.05).The levels of BP,FBG and HbA1c in the observation group were higher than those in the control group(P＜0.05).The BUN level,Scr level and UAER value in the observation group were significantly higher than those in the control group,while eGFR value was lower than that in the control group(P＜0.05).The levels of serum gastrin,glucagon,GIP and CCK in the observation group increased significantly(P＜0.05).Pearson correlation analysis indicated that the levels of gastrin,glucagon,GIP and CCK were positively correlated with BUN level,Scr level and UAER value(r＞0,P＜0.05),and negatively correlated with eGFR value(r＜0,P＜0.05).Multivariate Logistic regression analysis indicated that high BUN,high Scr,high UAER,low eGFR,as well as high gastrin,high GIP,and high CCK were the influencing factors for the occurrence of GD in DN patients(P＜0.05).The AUC of the constructed nomogram model was 0.977.Conclusion Elderly patients with DN complicated with GD may develop more severe renal function impairment and abnormal gastrointestinal hormone level.