1型糖尿病患者视网膜病变与肾功能的关系

Relationship between the diabetic retinopathy and renal function in patients with type 1 diabetes

摘要:

目的：探讨1型糖尿病患者视网膜病变与肾功能的相关性。

方法：选取2016-09/2018-05在我院眼科和内分泌科门诊及住院的1型糖尿病患者110例，根据眼底情况分为无糖尿病视网膜病变(NDR)组35例、非增生期糖尿病视网膜病变(BDR)组35例和增生期糖尿病视网膜病变(PDR)组40例，同时选取健康体检者40例作为对照组，分别记录受检者的一般情况，并检测尿白蛋白/尿肌酐比值、肾小球滤过率、血清肌酐、血尿素氮、胱抑素C、尿α1-微球蛋白和尿β2-微球蛋白等指标。

结果：四组受检者尿白蛋白/尿肌酐比值、肾小球率过滤、血清肌酐、血尿素氮、胱抑素C、尿α1-微球蛋白、尿β2-微球蛋白检测值有明显差异(均P<0.05)，糖尿病患者尿白蛋白/尿肌酐比值、血清肌酐、血尿素氮、胱抑素C、尿α1-微球蛋白、尿β2-微球蛋白明显升高，肾小球滤过率显著下降(均P<0.05)。糖尿病患者视网膜病变程度与尿白蛋白/尿肌酐比值呈正相关(r_s =0.498，P<0.05)，与肾小球滤过率呈负相关(r_s=-0.481，P<0.05)。PDR组患者大量尿蛋白(尿白蛋白/尿肌酐比值>300mg/g)发病率为67.5%，肾功能不全(肾小球滤过率<60mL/min)发病率高达65.0%。

结论：1型糖尿病患者视网膜病变与肾功能关系密切，肾功能异常患者糖尿病视网膜病变发生风险高，检测肾功能有助于预测其发生发展。

Abstract:

AIM: To explore the correlation between the degree of diabetic retinopathy and renal function in patients with type 1 diabetes mellitus.

METHODS: Totally 110 cases of patients with type 1 diabetes mellitus from September 2016 to May 2018 were chosen in our study. According to the fundus we divided all the cases into NDR group(without diabetic retinopathy), BDR group(non proliferation diabetic retinopathy)and PDR group(diabetic retinopathy), meanwhile the normal subjects were selected as the control group at the same time. The renal function related indicators like urinary albumin/creatinine(UACR), glomeruar filtration rate(GFR), serum creatinine(Scr), blood urea nitrogen(BUN), Cystatin C(Cys C), α1-micro globulin(α1-MG), β2-micro globulin(β2-MG)were detected and compared among the four groups.

RESULTS: There were statistically significant differences of urinary albumin/creatinine, glomeruar filtration rate, serum creatinine, blood urea nitrogen, Cystatin C, α1-micro globulin and β2-micro globulin among the four groups(all P<0.05). The urinary albumin/creatinine, serum creatinine, blood urea nitrogen, Cystatin C, α1-micro globulin andβ2-micro globulin were significantly increased, and the glomeruar filtration rate was significantly decreased in diabetic groups(all P<0.05). The correlation analysis showed that the degree of retinopathy was positively correlated with UACR(r_s=0.498, P<0.05), and negatively correlated with GFR(r_s=-0.481, P<0.05). The incidence rate of a large number of urinary protein was 67.5%, and which was as high as 65.0% of renal insufficiency with GFR<60mL/min in the PDR group.

CONCLUSION:The diabetic retinopathy is closely related to renal function in patients with type 1 diabetes. The patients with renal dysfunction have a high risk of diabetic retinopathy. Renal function may predict the occurrence and development of the diabetic retinopathy.