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目的 探讨2型糖尿病(T2DM)患者三酰甘油（TG）-总胆固醇（TC）-体质量（BW）指数（TCBI）与尿白蛋白/肌酐比值（UACR）的相关性及临床意义。方法 选择2018年1月至2023年11月就诊的T2DM患者600例，收集患者一般资料及TG、TC、UACR等指标。将受试者依据计算出的TCBI值分为低TCBI组、中TCBI组和高TCBI组，每组200例；依据UACR分为正常白蛋白尿组314例、微量白蛋白尿组232例和大量白蛋白尿组54例。应用Pearson相关性分析T2DM患者TCBI与临床特征相关性。多因素Logistic回归分析T2DM患者发生白蛋白尿的危险因素，并评估TCBI对白蛋白尿发生风险的预测价值。结果 高TCBI组lgUACR高于低、中TCBI组，中TCBI组对数转化后尿白蛋白/肌酐比值（lgUACR）高于低TCBI组（P<0.05）。大量白蛋白尿组TCBI水平高于正常及微量白蛋白尿组，微量白蛋白尿组高于正常白蛋白尿组（P<0.05）。TCBI与年龄（r=-0.14,P<0.01）、病程（r=-0.11,P<0.01）、高密度脂蛋白胆固醇（r=-0.12,P<0.01）呈负相关，与lgUACR(r=0.27,P<0.01)、体质量指数（r=0.30,P<0.01）、糖化血红蛋白（r=0.12,P<0.01）、空腹血糖（r=0.19,P<0.01）、低密度脂蛋白胆固醇（r=0.23,P<0.01）、血尿素（r=0.09,P<0.01）、血尿酸（r=0.25,P<0.01）、对数转化后胰岛素抵抗指数（r=0.14,P<0.01）呈正相关。多因素Logistic回归分析显示，TCBI为T2DM患者发生白蛋白尿的独立危险因素（P<0.01）。TCBI预测T2DM患者发生白蛋白尿曲线下面积为0.715，敏感度为63.6%，特异度为71.0%。结论 在T2DM患者中，TCBI升高与UACR升高相关，增加了白蛋白尿发生的风险，且对白蛋白尿的发生具有一定预测价值。
Abstract：Objective To investigate the association of triglycerides(TG)-total cholesterol-(TC)-body weight(BW) index(TCBI) with urinary albumin/creatinine ratio(UACR) in type 2 diabetes mellitus(T2DM) patients. Methods A total of 600 patients with T2DM who were treated between January 2018 and November 2023 were enrolled in this study. Clinical data and several parameters, such as TC, TG, TC, and UACR, were collected. According to calculated TCBI values, patients were divided into low TCBI(L-TCBI) group(n=200), medium TCBI(M-TCBI) group(n=200) and high TCBI(H-TCBI) group(n=201). According to UACR, patients were divided into normal albuminuria group(n=314), microalbuminuria group(n=232) and macroalbuminuria group(n=54). Pearson correlation analysis was applied to examine the correlation between TCBI and clinical characteristics in patients with T2DM. Multivariate logistic regression analysis was used to identify risk factors for albuminuria in T2DM patients and to evaluate the predictive value of TCBI for the risk of albuminuria onset. Results The logarithmically transformed UACR(lgUACR) was higher in the H-TCBI group than in the L-TCBI and M-TCBI groups, and higher in the M-TCBI group than in the L-TCBI group(P<0.05). The TCBI level in the macroalbuminuria group was higher than that in both the normal albuminuria and microalbuminuria groups, and higher in the microalbuminuria group than in the normal albuminuria group(P<0.05). TCBI showed negative correlations with age(r=-0.14, P<0.01), disease duration(r=-0.11, P<0.01), and high-density lipoprotein cholesterol(r=-0.12, P<0.01), while it showed positive correlations with lgUACR(r=0.27, P<0.01), body mass index(r=0.30, P<0.01), glycated hemoglobin(r=0.12, P<0.01), fasting blood glucose(r=0.19, P<0.01), low-density lipoprotein cholesterol(r=0.23, P<0.01), blood urea(r=0.09, P<0.01), blood uric acid(r=0.25, P<0.01), and the logarithmically transformed insulin resistance index(r=0.14, P<0.01). Multivariate logistic regression analysis indicated that TCBI was an independent risk factor for albuminuria(P<0.01). The area under the receiver operating characteristic curve of TCBI in predicting albuminuria was 0.715, with a sensitivity of 63.6% and a specificity of 71.0%. Conclusion In T2DM patients, increased TCBI is related to elevated UACR, increasing the risk of albuminuria and having certain predictive value for albuminuria.
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基本信息:
中图分类号:R587.1
引用信息:
[1]丁艺,尚东胜,邓霞,等.2型糖尿病患者TCBI与尿白蛋白/肌酐比值的相关性及临床意义[J].临床误诊误治,2026,39(02):41-48.
基金信息:
国家自然科学基金资助项目(32300625); 镇江市重点研发计划-社会发展项目(SH2023029)
2026-01-27
2026-01-27