血镁水平与糖尿病肾病

为探讨糖尿病肾病 (DN)患者血镁水平 ,以 1 5 9例 2型糖尿病 (T2DM)患者为研究对象 ,用xylidylblue比色法测定了其正常白蛋白尿期、微量白蛋白尿期 (早期DN)、临床DN及晚期DN血镁水平 ,与 2 0例正常对照组相比较 ;同时将 1 1 0例DN患者分为肾功能不全代偿组、失代偿组和肾功能衰竭组 ,将其血镁水平与 1 0 2例慢性肾小球肾炎 (CGN)患者相比较 ,组间比较采用t检验 ;对 79例T2DM正常白蛋白尿期及微量白蛋白尿期患者尿白蛋白排泄率 (UAER)与血镁水平进行了等级相关分析。结果表明 ,T2DM正常白蛋白尿期、早期DN及临床DN血镁水平降低 ,晚期DN血镁水平升高 ,各组与正常对照组相比存在显著性差异 (P <0 0 5或P <0 0 1 ) ;T2DMDN及CGN肾功能不全代偿期、失代偿期及肾功能衰竭期血镁水平渐升高 ,且肾功能处于同一期的DN和CGN相比 ,前者血镁水平均较后者显著降低 (P <0 0 1或P <0 0 5 ) ;T2DM正常白蛋白尿期和微量白蛋白尿期血镁水平与UAER呈负相关 (r=0 5 47,P <0 0 1 )。提示T2DM患者肾功能正常时存在低镁倾向 ,但晚期DN血镁水平升高 ;随着肾功能不全进展 ,DN和CGN患者血镁水平升高 ,但前者血镁水平仍较后者低 ,镁代谢紊乱与DM及其并发症的相互关系有待进一步研究 ;血镁水平测定可否作为DN的早期诊断指标亦

Serum Magnesium Levels in Type 2 Diabetic Patients with Diabetic Nephropathy

To evaluate circulating magnesium concentrations in patients with type 2 diabetes mellitus(T2DM)and incipient or overt or end stage diabetic nephropathy(DN),and to compare the circulating magnesium concentration in patients with DN and chronic glomerulonephritis(CGN)in different grades of chronic renal dysfunction.The serum magnesium was measured with xylidyl blue colorimetric method.The results showed that(1)serum magnesium levels were significantly reduced in T2DM patients with normoalbuminuria,microalbuminuria and clinical proteinuria when compared to control subjects(P<0.05,P<0.01),while serum magnesium levels were significantly higher in T2DM patients with renal dysfunction than that in control subjects(P<0.01);(2)serum magnesium levels were significantly reduced in DN patients with renal compensation,discompensation and renal failure when compared to CGN patients with renal function in the same stage(P<0.01,P<0.05);(3)serum magnesium showed a significantly negative correlation with urinary albumin excretion rate(UAER)in T2DM patients with normoalbuminuria and microalbuminuria(r=-0.547,P<0.01).There is a tendency for magnesium deficiency in patients with T2DM whose renal function is normal or compensation.With the degression of renal dysfunction serum magnesium levels increase in DN and CGN patients,while serum magnesium levels in DN patients are lower than in CGN patients.The correlation between magnesium disturbances and DM with its complications needs further study.The measurement of serum magnesium maybe will be a useful tool for the early diagnosis of DN.