中国北方寒地2型糖尿病患者摄盐量对早期肾损伤的影响-现代医学

中国北方寒地2型糖尿病患者摄盐量对早期肾损伤的影响

单位：哈尔滨医科大学第一临床医学院, 内分泌二科, 黑龙江哈尔滨 150001

分类号：R459.3

出版年·卷·期（页码）：2019·47·第八期（939-945）

摘要：

目的：探讨中国北方寒地2型糖尿病患者摄盐量对早期肾损伤的影响，以期为预防糖尿病肾脏病变及生活方式干预治疗工作提供参考。方法：我们调查了2016年11月至2018年4月期间的黑龙江省常住患者1 026例，根据摄盐量四分位数分位四组，比较四组之间摄盐量、肾小球滤过率（eGFR）及尿微量白蛋白（MAU）。早期肾损伤定义为eGFR<90 ml·min·1.73 m^-2和/或MAU的存在。结果：所有参与者中，男性647例，女性379例，平均摄盐量为13.60 g·d^-1；MAU 30~300 mg·d^-1有231人，检出率为22.51%；eGFR<90 ml·min·1.73 m^-2）有197人，检出率为19.20%。不同摄盐量组患者的24 h MAU水平有显著性差异（总体P值<0.01），高盐组患者24 h MAU显著高于低盐组（72.22±253.39 mmol vs.29.59±38.42 mmol，P<0.01），不同摄盐组患者的eGFR水平有显著差异（总体P值<0.05），高盐组患者eGFR明显低于低盐组（100.35±17.62 vs.104.47±19.91）。结论：在纳入研究的2型糖尿病患者中，高盐摄入会引起MAU升高及eGFR降低，早期预防及改善生活方式可减少摄盐对肾脏的影响。

Objective:To investigate the effect of salt intake on early renal injury in type 2 diabetic patients in cold areas of northern China, in order to provide important basis for the prevention of diabetic nephropathy and lifestyle intervention.Methods:We investigated 1 026 patients in Heilongjiang Province between November 2016 and April 2018. According to the salt intake quartile, salt intake, glomerular filtration rate and urinary microalbumin were compared among the four groups. Early renal injury was defined as the presence of an estimated glomerular filtration rate (eGFR) <90 ml·min·1.73 m^-2 and/or urinary microalbumin. Results:Of all the participants, 647 were males and 379 were females, the average salt intake was 13.60 g·d^-1, 231 were a MAU 30-300 mg·d^-1, the detection rate was 22.51%, and 197 were GFR<90 ml·min·1.73 m^-2), the detection rate was 19.20%. There was a significant difference in 24-hour MAU levels among different salt intake groups (P<0.01). The 24-hour MAU levels in the high salt group were significantly higher than those in low salt group (72.22±253.39) mmol vs. 29.59±38.42 mmol, P<0.01). The GFR levels in different salt intake groups were significantly different (P<0.05). The GFR levels in the high salt group were significantly lower than those in the low salt group (100.35±17.62 vs. 104.47±19.91).Conclusion:In type 2 diabetes mellitus patients included in the study, high salt intake may increase MAU and decrease GFR. Early prevention and improvement of lifestyle may reduce the effect of salt intake on kidney.

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