红细胞分布宽度与糖尿病微血管病变的相关性
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摘要
目的探讨红细胞体积分布宽度(RDW)与糖尿病(DM)微血管病变之间的相关性。方法连续选择2017年10月至2018年10月我院内分泌科住院的2型糖尿病患者共300例,分为单纯糖尿病组(即A组,n=75)、早期糖尿病肾病组(即B组,n=75)、糖尿病视网膜病变组(即C组,n=75)、糖尿病肾病合并糖尿病视网膜病变组(即D组,n=75),以及同期我院体检的健康对照组(即E组,n=50)。记录五组患者一般资料、生化指标、糖化血红蛋白、超敏C反应蛋白、C肽及血红细胞分布宽度。结果五组间年龄、性别构成比、吸烟史、饮酒史、TG、LDL-C、HDL-C比较,差异无统计学意义(P>0.05);结果见表1。与E组相比,A、B、C、D四组的BMI及舒张压明显升高,差异均有统计学意义(P<0.05);在A、B、E三组以及A、D、E三组中,病程、收缩压、FBG、HbA1c、hs-CRP、ΔC肽、RDW、总胆固醇指标比较差异均有统计学意义(P均<0.05);在A、C、E三组中,病程、收缩压、FBG、HbA1c、TC、ΔC肽各指标三组组间比较差异均有统计学意义(P均<0.05);RDW与hs-CRP、FBG、总胆固醇、尿微量蛋白呈正相关,与ΔC肽值呈负相关,与其他指标无明显相关性。以有早期糖尿病肾病为因变量,其他临床资料为自变量,进行多因素Logistic回归分析,结果显示病程、HbA1c、RDW、收缩压、总胆固醇、ΔC肽进入回归方程,提示RDW为糖尿病微血管病变的独立危险因素。结论 RDW是早期DN的独立危险因素,可用于预测早期DN的发生。RDW与糖尿病视网膜病变无明显相关性。
Objective To investigate the correlation between erythrocyte volume distribution width(RDW) and microangiopathy in diabetes mellitus. Methods From October 2017 to October 2018, 300 patients with type 2 diabetes mellitus were selected in our hospital.They were divided into simple type 2 diabetes mellitus group(n = 75), simple early diabetic nephropathy group(n=75), simple diabetic retinopathy group(n=75), type 2 diabetes mellitus with diabetic nephropathy and diabetic retinopathy group(n=75). And the healthy control group(n=50) of physical examination in our hospital during the same period. The general data, biochemical indexes and the distribution width of red blood cells in five groups were recorded. Results There were no significant differences in age, gender composition ratio,smoking history, drinking history, TG, LDL-C, and HDL-C between the five groups(P>0.05). Compared with group E, the BMI and diastolic blood pressure of group A, B, C and D were significantly higher, the difference was statistically significant(P<0.05); in group A,B, E and A, D, E Among the three groups, the differences of disease course, systolic blood pressure, FBG, HbA1 c, hs-CRP, ΔC peptide,RDW and total cholesterol were statistically significant(P<0.05); in groups A, C and E. There were statistically significant differences in the duration of disease, systolic blood pressure, FBG, HbA1 c, TC, ΔC peptide between the three groups(P<0.05); the results are shown in Table 1. RDW was positively correlated with hs-CRP, FBG, total cholesterol, and urine microprotein, and negatively correlated with ΔC peptide and value, and had no significant correlation with other indicators. Multivariate logistic regression analysis was performed with early diabetic nephropathy as the dependent variable and other clinical data as independent variables. The results showed that the course of disease, HbA1 c, RDW, systolic blood pressure, total cholesterol, and ΔC peptide entered the regression equation, suggesting that RDW is a diabetic microangiopathy. Independent risk factors. Conclusion RDW is an independent risk factor for early DN and can be used to predict the occurrence of early DN. There was no significant correlation between RDW and diabetic retinopathy.
Objective To investigate the correlation between erythrocyte volume distribution width(RDW) and microangiopathy in diabetes mellitus. Methods From October 2017 to October 2018, 300 patients with type 2 diabetes mellitus were selected in our hospital.They were divided into simple type 2 diabetes mellitus group(n = 75), simple early diabetic nephropathy group(n=75), simple diabetic retinopathy group(n=75), type 2 diabetes mellitus with diabetic nephropathy and diabetic retinopathy group(n=75). And the healthy control group(n=50) of physical examination in our hospital during the same period. The general data, biochemical indexes and the distribution width of red blood cells in five groups were recorded. Results There were no significant differences in age, gender composition ratio,smoking history, drinking history, TG, LDL-C, and HDL-C between the five groups(P>0.05). Compared with group E, the BMI and diastolic blood pressure of group A, B, C and D were significantly higher, the difference was statistically significant(P<0.05); in group A,B, E and A, D, E Among the three groups, the differences of disease course, systolic blood pressure, FBG, HbA1 c, hs-CRP, ΔC peptide,RDW and total cholesterol were statistically significant(P<0.05); in groups A, C and E. There were statistically significant differences in the duration of disease, systolic blood pressure, FBG, HbA1 c, TC, ΔC peptide between the three groups(P<0.05); the results are shown in Table 1. RDW was positively correlated with hs-CRP, FBG, total cholesterol, and urine microprotein, and negatively correlated with ΔC peptide and value, and had no significant correlation with other indicators. Multivariate logistic regression analysis was performed with early diabetic nephropathy as the dependent variable and other clinical data as independent variables. The results showed that the course of disease, HbA1 c, RDW, systolic blood pressure, total cholesterol, and ΔC peptide entered the regression equation, suggesting that RDW is a diabetic microangiopathy. Independent risk factors. Conclusion RDW is an independent risk factor for early DN and can be used to predict the occurrence of early DN. There was no significant correlation between RDW and diabetic retinopathy.
引文
[1]廖涌.中国糖尿病学的流行病学现状与展望[J],重庆医科大学学报,2015,40(7):1042-1044.
[2]Adler AI,Stevens RJ,Manley SE,et al.developement and progression of nephropathy in type 2 diabetes:The United Kingdom Prospective Diabetes Study(UKPDS64)[J].Kidney Int,2003,63(1):225-232.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[4]龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[5]赵立华,马静,谢云.血清C肽水平变化与2型糖尿病微血管病变的相关性[J].中国糖尿病杂志,2015,23(5):430-433.
[6]Bhatt MP,Lim YC,Hwang J,et al.C-Peptide prevents hyper glycemiainduced endothelial apoptosis through inhibition of reactive oxygen speciesmediated transglutaminase 2 activation[J].Diabetes,2013,62:243-253.
[7]Weiss G,Goodnough LT Anemia of chronic disease[J].N Engl J Med2005,35(2):1011-1023.
[8]N.Malandrino,W.C.Wu,T.H.Taveira,et al.Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes[J].Diabetologia,2012,55:226-235.
[9]雍军光,阮萍,冯博华,等.糖尿病肾病患者红细胞形态功能变化与病程发展的关联性研究[J].暨南大学学报,2013,(6):610-614.
[10]魏聪,申锷,胡兵.糖尿病大血管病变的研究进展[J].上海交通大学学报(医学版),2010,30:1292-1296.
[2]Adler AI,Stevens RJ,Manley SE,et al.developement and progression of nephropathy in type 2 diabetes:The United Kingdom Prospective Diabetes Study(UKPDS64)[J].Kidney Int,2003,63(1):225-232.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[4]龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[5]赵立华,马静,谢云.血清C肽水平变化与2型糖尿病微血管病变的相关性[J].中国糖尿病杂志,2015,23(5):430-433.
[6]Bhatt MP,Lim YC,Hwang J,et al.C-Peptide prevents hyper glycemiainduced endothelial apoptosis through inhibition of reactive oxygen speciesmediated transglutaminase 2 activation[J].Diabetes,2013,62:243-253.
[7]Weiss G,Goodnough LT Anemia of chronic disease[J].N Engl J Med2005,35(2):1011-1023.
[8]N.Malandrino,W.C.Wu,T.H.Taveira,et al.Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes[J].Diabetologia,2012,55:226-235.
[9]雍军光,阮萍,冯博华,等.糖尿病肾病患者红细胞形态功能变化与病程发展的关联性研究[J].暨南大学学报,2013,(6):610-614.
[10]魏聪,申锷,胡兵.糖尿病大血管病变的研究进展[J].上海交通大学学报(医学版),2010,30:1292-1296.