| 宋子华,王娜,李吉镇,刘雷.2型糖尿病患者血清胆红素与尿微量白蛋白的关联性[J].济宁医学院学报,2022,45(2):89-93 |
| 2型糖尿病患者血清胆红素与尿微量白蛋白的关联性 |
| Correlation between serum bilirubin and microalbuminuria in patients with type 2 diabetic mellitus |
| 投稿时间：2021-03-09 |
| DOI：10.3969/j.issn.1000-9760.2022.02.004 |
| 中文关键词: 2型糖尿病;胆红素;尿微量白蛋白 |
| 英文关键词: Type 2 diabetic mellitus;Bilirubin;Microalbumin |
| 基金项目:济宁医学院附属医院“苗圃”科研计划项目(MP-MS-2019-009)；济宁医学院教师扶持基金(JYFC2019FKJ178) |
| 作者 | 单位 | 邮编 | | 宋子华 | 济宁医学院临床医学院 | 272013 | | 王娜* | 济宁医学院附属医院 | 272029 | | 李吉镇 | 济宁医学院临床医学院 | 272013 | | 刘雷 | 济宁医学院附属医院 | 272029 |
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| 中文摘要: |
| 目的 探讨2型糖尿病患者血清胆红素与尿微量白蛋白的关联性。 方法 纳入2017年6月1日至2018年5月31日济宁医学院附属医院收治的2型糖尿病患者766例，收集其临床资料，根据尿微量白蛋白水平分为正常组和异常组，尿微量白蛋白 < 30mg/L为正常组(626例)，尿微量白蛋白≥30mg/L为异常组(140例)。分析血清总胆红素、直接胆红素、间接胆红素水平与尿微量白蛋白的关联性。 结果 调整相关混杂因素后平滑曲线拟合显示总胆红素、直接胆红素、间接胆红素水平与尿微量白蛋白呈U型曲线关系。总胆红素 < 13.4mol/L时，总胆红素每增加1μmol/L，尿微量白蛋白升高风险降低21%(OR=0.79, 95%CI 0.71~0.88, P < 0.05)；总胆红素≥13.4μmol/L，总胆红素每增加1μmol/L，尿微量白蛋白升高风险增加9%(OR=1.09, 95%CI 1.03~1.15, P < 0.05)；直接胆红素 < 4.1μmol/L时，直接胆红素每增加1μmol/L，尿微量白蛋白升高风险降低34%(OR=0.66, 95%CI 0.49~0.89, P < 0.05)；直接红素≥4.1μmol/L，总胆红素每增加1μmol/L，尿微量白蛋白升高风险增加120%(OR=2.20, 95%CI 1.37~3.53, P < 0.05)；间接胆红素 < 7.3μmol/L时, 间接胆红素每增加1μmol/L，尿微量白蛋白升高风险降低47%(OR=0.53, 95%CI 0.41~0.70, P < 0.05)。 结论 2型糖尿病患者生理浓度下的总胆红素、直接胆红素、间接胆红素与尿微量白蛋白呈U型曲线关系，总胆红素、直接胆红素、间接胆红素轻度升高可以降低尿微量白蛋白。 |
| 英文摘要: |
| Objective To investigate the correlation between serum bilirubin and microalbuminuria in patients with type 2 diabetic mellitus. Methods This study was carried out on 766 patients with type 2 diabetic mellitus in the Affiliated Hospital of Jining Medical University from Jun.1, 2017 to May 31, 2018, and their clinical data were collected and they were divided into a normal group of 626 cases with urinary microalbumin < 30 mg/L and an abnormal group of 140 cases with urinary microalbumin ≥30 mg/Laccording to urinary microalbumin.The correlation between serum total bilirubin, direct bilirubin, indirect bilirubin levels and urinary microalbumin was analyzed. Results Smoothed curve fitting after adjusting relevant confounders showed a U-shaped curve relationship between total bilirubin, direct bilirubin, and indirect bilirubin levels and urinary microalbumin.For total bilirubin < 13.4mol/L, the risk of elevated urinary microalbumin decreased by 21% for each 1 μmol/L increase in total bilirubin (OR=0.79, 95%CI 0.71~0.88, P < 0.01);for total bilirubin ≥13.4 μmol/L, the risk of elevated urinary microalbumin increased by 9% for each 1 μmol/L increase in total bilirubin(OR=1.09, 95%CI 1.03~1.15, P < 0.01);for direct bilirubin < 4.1 μmol/L, the risk of elevated urinary microalbumin was reduced by 34% for each 1 μmol/L increase in direct bilirubin(OR=0.66, 95%CI 0.49~0.89, P < 0.01);for direct bilirubin ≥4.1 μmol/L, the risk of elevated urinary microalbumin increased by 120% for each 1 μmol/L increase in total bilirubin (OR=2.20, 95%CI 1.37~3.53, P < 0.01);for indirect bilirubin < 7.3 μmol/L, the risk of elevated urinary microalbumin decreased by 47% for each 1 μmol/L increase in indirect bilirubin (OR=0.53, 95%CI 0.41~ 0.70, P < 0.01). Conclusion There is a U-shaped relationship between the levels of total bilirubin, direct bilirubin, indirect bilirubin, and urinary microalbumin of patients with type 2 diabetic mellitus, and at physiological concentrations, slight increase in total bilirubin, direct bilirubin and indirect bilirubin could reduce urinary microalbumin. |
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