Association of C-reactive Protein and Traditional Risk Factors with Nephropathy in the Elderly Patients with Diabetes

目的：探討老年第2型糖尿病患的發炎反應蛋白C(CRP)、傳統危險因數與罹患腎臟病變的相關性。材料與方法：我們在某醫學中心的糖尿病門診選取65歲以上的第2型糖尿病患，除了收集病患的基本資料外，並安排血液生化及尿液白蛋白檢查，其中，血液生化檢查包括空腹血糖、血脂肪、發炎反應蛋白C、糖化血色素和肌酸酐；微白蛋白尿的定義爲尿液白蛋白與肌酸酐的比值在30與300mg/g之間，若比值大於300mg/g爲巨白蛋白尿。結果：總共有261位病患參加，平均年齡爲73.0±5.6歲，其中罹患微白蛋白尿與巨白蛋白尿的人數與盛行率分別爲76人(29.1%)與43(16.5%)。Spearman's相關分析顯示發炎反應蛋白C與小便中白蛋白與肌酸酐的比值有關。多變項分析顯示影響白蛋白尿存在最重要的因素是罹患糖尿病時間長短，罹病十年以上者的危險性增加爲2.45倍(OR=2.45, 95% CI=1.39-4.30, p=0.002)；其次是腎絲球過濾速率(OR=0.98, 95% CI=0.97-1.00, p=0.006)，至於發炎反應蛋白C也和白蛋白尿存在有關(OR=1.27, 95% CI=1.00-1.62, p=0.04)。結論：老年第2型糖尿病患的白蛋白尿和發炎反應蛋白C有關，其他相關影響因素包括罹患糖尿病時間長短和腎絲球過濾速率。

關鍵字

白蛋白尿；發炎反應蛋白C ；糖尿病；老年人；腎臟病變

並列摘要

Objective: To investigate the relationship of C-reactive protein (CRP) and traditional risk factors with nephropathy in the elderly patients with diabetes. Methods: Patients with type 2 diabetes, 65 years old and over were consecutively recruited from a diabetic center. Information regarding each participant's socio-demographic characteristics and medical history were gathered. Fasting plasma sugar, serum lipid, creatinine, CRP, HbA1C and urinary albumin concentration were measured in all study subjects. Albuminuria was defined as micro-albuminuria if the urinary albumin-creatinine ratio (ACR) was ≥30 and ＜300 mg/g, and as macro-albuminuria if the ACR was ≥300 mg/g. Results: A total of 261 patients, aged 73.0+5.6 years were recruited, and the numbers (rates) of micro- and macro-albuminuria were respectively 76 (29.1%) and 43 (16.5%). Spearman's correlation analysis showed that CRP was correlated significantly with ACR level. Logistic regression analysis revealed that the most significant factor associated with abnormal albuminuria was the duration of diabetes. For elderly patients who had diabetes for 10 or more years, the risk of developing abnormal albuminuria was 2.5 times greater (OR=2.45, 95% CI=1.39-4.30, p=0.002). Glomerular filtration rate (GFR) was the second significant factor related to albuminuria (OR=0.98, 95% CI=0.97-1.00, p=0.006). CRP was also significantly associated with abnormal albuminuria (OR=1.27, 95% CI=1.00-1.62, p=0.04). Conclusions: Low-grade inflammation as represented by serum CRP levels is significantly related to the presence of albminuria in this sample of Chinese elderly patients with type 2 diabetes. Other significant factors associated with abnormal albuminuria include the duration of diabetes and GFR.

並列關鍵字

albuminuria ； C-reactive protein ； diabetes ； elderly ； nephropathy

國際替代計量

Association of C-reactive Protein and Traditional Risk Factors with Nephropathy in the Elderly Patients with Diabetes

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