2型糖尿病患者血清脂蛋白(a)与糖尿病肾病的相关性

李平; 聂钦; 冯霄; 秦亚兰; 徐焱成

doi:10.14188/j.1671-8852.2023.0543

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2型糖尿病患者血清脂蛋白(a)与糖尿病肾病的相关性

临床医学研究 | 更新时间：2026-11-05

- 2型糖尿病患者血清脂蛋白(a)与糖尿病肾病的相关性
- Correlation between serum lipoprotein(a) and diabetic kidney disease in patients with type 2 diabetes mellitus
- 武汉大学学报（医学版） 2025年46卷第3期页码：375-380
- 作者机构：
  
  武汉大学中南医院内分泌科湖北武汉 430071
- 作者简介：
  
  李平，女，1995—，医学硕士生，主要从事糖尿病及其相关并发症的临床与基础研究，E⁃mail: lipingxgl@163.com
  徐焱成，男，1950—,主任医师，博士生导师，主要从事内分泌与代谢疾病的临床与基础研究，E⁃mail: xjl100901@whu.edu.cn
- 基金信息：
- DOI：10.14188/j.1671-8852.2023.0543
  中图分类号： R587.1
- 收稿：2023-10-15，
  
  纸质出版：2025-03-25
- 稿件说明：
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李平,聂钦,冯霄等.2型糖尿病患者血清脂蛋白(a)与糖尿病肾病的相关性[J].武汉大学学报（医学版）,2025,46(03):375-380.

LI Ping,NIE Qin,FENG Xiao,et al.Correlation between serum lipoprotein(a) and diabetic kidney disease in patients with type 2 diabetes mellitus[J].Medical Journal of Wuhan University,2025,46(03):375-380.
李平,聂钦,冯霄等.2型糖尿病患者血清脂蛋白(a)与糖尿病肾病的相关性[J].武汉大学学报（医学版）,2025,46(03):375-380. DOI： 10.14188/j.1671-8852.2023.0543.

LI Ping,NIE Qin,FENG Xiao,et al.Correlation between serum lipoprotein(a) and diabetic kidney disease in patients with type 2 diabetes mellitus[J].Medical Journal of Wuhan University,2025,46(03):375-380. DOI： 10.14188/j.1671-8852.2023.0543.

摘要

目的

探讨2型糖尿病（T2DM）患者血清脂蛋白(a)[Lp(a)]水平与糖尿病肾病（DKD）的关系。

方法

研究对象为2 042名T2DM患者。根据患者预估肾小球滤过率（eGFR）水平将患者分为DKD组和NDKD组，比较两组之间的人口学指标及检验指标的差异，使用Spearman相关分析Lp（a）与各指标之间的相关性，采用二元Logistic回归分析Lp(a)升高[Lp(a)≥300 mg·L

-1

]

的相关危险因素及T2DM患者并发DKD的相关危险因素。

结果

DKD组与NDKD 组比较，DKD组患者的年龄较NDKD组高，糖尿病病程更长，使用胰岛素比例更高，高血压患病率更高，胰岛素抵抗指数（HOMA⁃IR）、胰岛素分泌指数（HOMA⁃β）、血尿酸（SUA）、胱抑素C(CysC)、尿素氮（BUN）、血肌酐（Scr）、Lp(a)水平更高，白蛋白（ALB）、游离脂肪酸（NEFA)水平偏低，差异有统计学意义（均

0.05）；相关性分析显示：Lp（a）与HOMA⁃IR、SUA、eGFR呈负相关

与CysC、BUN、胆固醇（TC）、高密度脂蛋白（HDL⁃C）、低密度脂蛋白（LDL⁃C）呈正相关（均为

0.05）；二元Logistic回归分析发现男性（

=1.488）为Lp(a)升高的独立危险因素，eGFR（

=0.537）为Lp(a)升高的独立保护因素，糖尿病病程(

=1.054)、高血压病史(

=2.562)、使用胰岛素(

=0.761)、SUA(

=1.324)、HOMA⁃IR(

=1.017)、BUN(

=1.219)、Lp(a)(

=2.307)为T2DM患者并发DKD

的独立危险因素（均为

0.05）。

结论

在T2DM患者中，血清Lp(a)水平与DKD具有较好的相关性。

Abstract

Objective

To investigate the relationship between serum lipoprotein(a) [Lp(a)] levels and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

Methods

The study population consisted of 2 042 patients with T2DM. Patients were divided into DKD and NDKD groups according to their estimated glomerular filtration rate (eGFR) levels

and the differences in demographic and test indicators between the two groups were compared. The correlation between Lp(a) and each indicator was analyzed using Spearman correlation analysis

and binary logistic regression was used to analyze the risk associated with elevated Lp(a)

Lp(a) ≥300 mg·L

-1

and risk factors associated with concurrent DKD in T2DM patients.

Results

Comparing the DKD group with the NDKD group

patients in the DKD group were older than the NDKD group

had a longer duration of diabetes mellitus

a higher proportion of insulin use

a higher prevalence of hypertension

higher levels of insulin resistance index (HOMA⁃IR)

insulin secretion index (HOMA⁃β)

blood uric acid (SUA)

cystatin C (CysC)

urea nitrogen (BUN)

blood creatinine (Scr)

Lp (a) levels were higher

and the levels of albumin (ALB) and free fatty acid (NEFA) were lower

with statistically significant differences (all

0.05). Correlation analysis showed that Lp(a) was negatively correlated with HOMA⁃IR

SUA

and eGFR

and positively correlated with CysC

BUN

cholesterol (TC)

high⁃density lipoprotein (HDL⁃C)

and low⁃density lipoprotein (LDL⁃C) (

0.05); Binary logistic regression analysis revealed that male (

=1.488) was an independent risk factor for elevated Lp(a)

eGFR (

=0.537) was an independent protective factor for elevate

d Lp(a)

and the duration of diabetes (

=1.054)

history of hypertension (

=2.562)

use of insulin (

=0.761)

SUA (

=1.324)

HOMA⁃IR (

=1.017)

BUN (

=1.219)

and Lp(a) (

=2.307) were independent risk factors for concomitant DKD in patients with T2DM (

0.05).

Conclusion

In patients with T2DM

serum Lp(a) level has a good correlation with DKD.

关键词

Keywords

references

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