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投稿时间：2025-07-18 网络发布日期：2025-09-19
投稿时间：2025-07-18 网络发布日期：2025-09-19
中文摘要: 目的 探讨身体质量指数（BMI）正常的2型糖尿病（T2DM）患者中糖尿病肾病（DKD）的发生与内脏脂肪面积（VFA）的相关性。方法 收集2022年8月18日至2024年4月8日浙江大学医学院附属第二医院内分泌科收治的309例BMI正常（18.5~＜24.0kg/m2）T2DM患者的资料进行横断面研究，根据是否有DKD分为DKD组（n= 90）和非DKD组（n=219）。比较两组患者的基线资料和实验室指标等数据的差异。利用Spearman相关性分析和logistic 回归分析研究VFA与DKD的相关性，绘制受试者工作特征（ROC）曲线评估VFA在DKD诊断中的价值。结果 DKD组患者VFA高于非DKD组，差异有统计学意义［（70.16±25.79）cm2 vs（61.93±22.17）cm2，t= 2.823，P= 0.005］。Spearman相关性分析结果显示DKD与年龄（r=0.218，P＜0.01）、病程（r=0.202，P＜0.01）、VFA（r= 0.157，P= 0.006）、三酰甘油（r=0.170，P= 0.003）、血肌酐（r=0.499，P＜0.01）、血尿酸（r=0.318，P＜0.01）、尿白蛋白/尿肌酐比值（r=0.532，P＜0.01）呈正相关。单因素logistic回归分析结果显示VFA是DKD发生的危险因素（OR= 1.015，95%CI:1.004~1.025，P= 0.006），在调整性别、BMI、病程等混杂因素后VFA仍是DKD的危险因素（OR= 1.024，95%CI:1.008~1.040，P= 0.003）。ROC曲线分析结果表明，VFA预测DKD的截断值为71.05 cm2，敏感度为0.467，特异度为0.726，曲线下面积（AUC）为0.600（95%CI:0.529~0.670）。结论 在BMI正常的T2DM患者中，VFA与DKD呈正相关，且VFA是DKD的危险因素。随着VFA的增加，DKD的患病风险增高。
Abstract:Objective To investigate the correlation between visceral fat area (VFA) and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients with normal body mass index (BMI). Methods A cross-sectional study was conducted on 309 T2DM patients with normal BMI (18.5-24.0 kg/m2) in the Department of Endocrinology of the Second Affiliated Hospital of Zhejiang University School of Medicine from August 18, 2022 to April 8, 2024. The patients were divided into DKD group (n=90) and non-DKD group (n=219) according to whether DKD was merged or not. Baseline data, laboratory indicators between the two groups were compared. Spearman correlation analysis and logistic regression analysis were used to investigate the correlation between VFA and DKD. Receiver operating characteristic (ROC) curve was drawn to evaluate the value of VFA in the diagnosis of DKD. Results VFA in DKD group was higher significantly than that in the non-DKD group [ (70.16±25.79) cm2 vs (61.93±22.17) cm2, t= 2.823, P= 0.005]. The results of Spearman correlation analysis showed that DKD was positively correlated with age (r=0.218, P＜<0.01), disease duration (r=0.202, P＜0.01), VFA (r=0.157, P= 0.006), triglycerides (r=0.170, P= 0.003), serum creatinine (r=0.499, P＜0.01), serum uric acid (r=0.318, P＜0.01), and urine albumin-to-creatinine ratio (r=0.532, P＜0.01), respectively. The result of univariate logistic regression analysis showed that VFA was a risk factor for DKD (OR= 1.015, 95%CI: 1.004-1.025, P= 0.006). After adjusting for confounding factors such as gender, BMI, and disease duration, VFA remained be a risk factor for DKD (OR= 1.024, 95%CI: 1.008-1.040, P= 0.003). The ROC curve analysis results showed that the cut-off value of VFA for predicting DKD was 71.05 cm2, the sensitivity was the specificity was 0.726, and the area under the curve (AUC) was 0.600 (95% CI< 0.529-0.670). Conclusion In T2DM patients with normal BMI, VFA is positively correlated with DKD, and VFA is a risk factor for DKD. The risk of DKD increases with the increase of VFA.
文章编号： 中图分类号： 文献标志码：A
基金项目:浙江省自然科学基金联合基金重点项目（LHDMZ24H070001）
附件
| 作者 | 单位 |
| 张佳芝 | 浙江大学医学院,浙江 杭州 310058 |
| 郑超 | 浙江大学医学院附属第二医院内分泌科,浙江 杭州 310000 |
| 潘洁 | 浙江大学医学院附属第二医院内分泌科,浙江 杭州 310000 |
| 周崯莹 | 浙江大学医学院,浙江 杭州 310058 |
引用文本：
张佳芝,郑超,潘洁,等.身体质量指数正常的2型糖尿患者内脏脂肪面积与糖尿病肾病的相关性[J].中国临床研究,2025,38(9):1329-1333.
张佳芝,郑超,潘洁,等.身体质量指数正常的2型糖尿患者内脏脂肪面积与糖尿病肾病的相关性[J].中国临床研究,2025,38(9):1329-1333.