Relationship of plasma fibrinogen and non-high-density lipoprotein cholesterol with type 2 diabetic nephropathy in the elderly / 中华老年医学杂志

ABSTRACT

Objective To investigate the relationship of plasma fibrinogen (FIB) and non-highdensity lipoprotein cholesterol (non-HDL-C) with diabetic nephropathy in the elderly with type 2 diabetes. Methods Totally 152 patients (aged 60 years and over) with type 2 diabetics were divided into normal albuminuria (UAER＜30 mg/24 h,n=89) and abnormal albuminuria (UAER≥ 30 mg/24 h,n=63) groups,with high FIB (＞4.00 g/L,n=88) and normal FTB (2.00-4.00 g/L,n=64)sub-groups.The body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),postprandial blood glucose (2 hPG),glycated hemoglobin (HbAlc),serum triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),FIB and 24-hour urinary albumin excretion rate (UAER) were measured.The non-HDL-C and estimated glomerular filtration rate (eGFR) were calculated. Results Compared with normal albuminuria group,the values of age,hypertension rate,SBP,Scr and FIB in abnormal albuminuria group were increased [(74.6 ± 7.3) years,57 cases (90.5％),(146.8±23.2)mm Hg,(1.010.7)μmol/L,(4.8±1.5)g/Lvs.(71.6±7.2)years,59 cases (66.3％),(137.7±19.2) mm Hg,(0.8±0.3)μmol/L,(4.2±1.3)g/L,t=-2.536,-2.656,- 2.474,-2.857,x2 =11.936,all P＜0.05] while eGFR was significantly decreased [(68.5±31.2)ml · min-1 · 1.73 m-2 vs.(81.4±25.9)ml · min-1 · 1.73m-2,t=2.791,P＜0.05].The number of patients with high FIB was enhanced in abnormal albuminuria group than normal albuminuria group[45 cases (71.4％) vs. 18 cases (28.6％),x2 =8.085,P=0.004]. The proportion of abnormal albuminuria in high FIB group was lower than that in normal FIB group [(62.6±30.5) ml· min-1 · 1.73 m-2 vs.(83.2±28.7) ml· min-1 · 1.73 m 2,t=2.459,P=0.017].The Pearson analysis revealed that UAER was positively correlated with FIB,TG,TC and non-HDL-C (r=0.276,0.268,0.243,0.176,all P＜0.05).Stepwise regressive analysis showed that FIB was an independent risk factors of urinary albumin in the elderly with type 2 diabetes.Conclusions Higher levels of FIB and non-HDL-C are well correlated with diabetic nephropathy in the elderly with type 2 diabetes.