摘要: |
目的: 探讨非透析糖尿病肾病患者的营养状态与血清钙镁比值(Ca/Mg)的相关性。方法: 选择2017年1月至2019年6月于上海市第八人民医院肾内科就诊非透析糖尿病肾病患者139例,根据其血清Ca/Mg大小分为:低Ca/Mg组(Ca/Mg≤3.5,n=32)、中Ca/Mg组(3.5n=56)、高Ca/Mg组(Ca/Mg≥4.5,n=51)。检测各组患者生化指标,分析患者的营养状态与血清Ca/Mg的相关性。结果: 随着Ca/Mg的升高,非透析糖尿病肾病患者白蛋白(Alb)、血红蛋白(Hb)水平呈升高趋势,主观综合营养评价法(SGA)评分中营养不良患者比例呈降低趋势,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,非透析糖尿病肾病患者血清Ca/Mg与年龄(r=-0.199)、高敏C反应蛋白(hsCRP)水平(r=-0.294)、尿素氮(BUN)水平(r=-0.328)、血清肌酐(SCr)水平(r=-0.366)负相关(P<0.05);与估算肾小球滤过率(eGFR,r=0.266)、全段甲状旁腺激素(iPTH,r=0.101)、Alb (r=0.193)及Hb水平(r=0.266)正相关(P<0.05);与性别、三酰甘油(TG)、胆固醇(TC)、尿白蛋白肌酐比值(ACR)等指标无显著相关性。多因素线性回归分析显示,非透析糖尿病肾病患者血清Ca/Mg与hsCRP水平及年龄负相关,与Alb、Hb及iPTH水平正相关(P<0.05)。多因素logistic回归显示,血清Ca/Mg与非透析糖尿病肾病患者营养不良的发生存在独立相关关系(HR=0.506,95%CI 0.267~0.961,P=0.038)。结论: 非透析糖尿病肾病患者的营养状态与血清Ca/Mg相关,血清Ca/Mg可能是该类患者发生营养不良的独立危险因素。 |
关键词: 糖尿病肾病 慢性肾脏病 钙镁比值 营养状态 |
DOI:10.12025/j.issn.1008-6358.2021.20202507 |
分类号:R587.1 |
基金项目:国家自然科学基金(81770741),上海市徐汇区肾内科高原学科项目(SHXH201720). |
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Influencing factors of serum Ca/Mg ratio and its relation with nutritional status in patients with non-dialysis dependent diabetic kidney disease |
GUO Jie1, YUAN Li1, WANG Nian-song1,2, WANG Feng1,2
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1.Department of Nephrology, the Eighth People's Hospital, Shanghai 200235, China;2.Department of Nephrology, the Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
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Abstract: |
Objective: To analyze the relationship between nutritional status and serum Ca/Mg ratio in patients with non-dialysis-dependent diabetic kidney disease.Methods: A total of 139 patients with non-dialysis diabetic kidney disease who visited Shanghai Eighth People's Hospital from January 2017 to June 2019 were selected and divided into three groups according to serum Ca/Mg ratio:group A (≤ 3.5, n=32), group B (3.5-4.5, n=56) and group C (≥ 4.5, n=51). Biochemical indexes of patients in each group were detected, and the correlation between nutritional status and serum Ca/Mg ratio was analyzed.Results: With the increase of Ca/Mg ratio, the levels of albumin (Alb) and hemoglobin (Hb) significantly increased (P<0.05), while the proportion of malnourished patients in the subjective global assessment of nutrition (SGA) score showed a decreasing trend (P<0.05). Spearman correlation analysis showed that the serum Ca/Mg ratio was negatively correlated with age (r=-0.199), the level of high-sensitivity C-reactive protein (hsCRP, r=-0.294), blood urea nitrogen (BUN, r=-0.328) and serum creatinine (SCr, r=-0.366), and it was positively correlated with the level of eGFR (r=0.266), intact parathyroid hormone (iPTH, r=0.101), Alb (r=0.193) and Hb (r=0.266). The above correlations were all statistically significant (P<0.05). However, the serum Ca/Mg ratio had no correlation with gender and the levels of albumin/creatinine ratio (ACR), total cholesterol (TC), or triglyceride (TG). The multivariate linear regression analysis result showed that serum Ca/Mg ratio was negatively correlated with hsCRP level and age, but positively correlated with Alb, Hb, and iPTH levels. Multivariate logistic regression showed that the Ca/Mg ratio was independently associated with the risk of malnutrition in non-dialysis patients with diabetic kidney disease (HR=0.506, 95%CI 0.267-0.961, P=0.038).Conclusions: Serum Ca/Mg ratio was correlated with nutritional status in non-dialysis patients with diabetic kidney disease, and it might be used for the assessment of nutritional status in patients with non-dialysis diabetic kidney disease. |
Key words: diabetic kidney disease chronic kidney disease Ca/Mg ratio nutritional status |