Study On The Relationship Between Urinary Albumin And Blood Glucose Increment 2 Hours After Glucose Load In Patients With Type 2 Diabetes Mellitus

Objective: The purpose of this study was to investigate the relationship between urinary albumin and blood glucose increment 2 hours after oral glucose tolerance test glucose load in patients with type 2 diabetes mellitus.Methods:1.Use of electronic medical record system,data of type 2 diabetes patients admitted to the department of endocrinology,second hospital of hebei medical university from June 2018 to December 2019 were retrospectively collected.According to inclusion and exclusion criteria,a total of 120 subjects were included.Collect patients basic information(gender,age,course of the disease,height,weight,blood pressure)and biochemical indicators(creatinine,uric acid,cholesterol,triglycerides,low density lipoprotein,high density lipoprotein),blood sugar index {glycosylated hemoglobin,fasting blood glucose(FBG),fasting c-peptide and blood sugar 2 hours after glucose load(2 h PG),2 hours c-peptide},random urine albumin creatinine ratio(UACR).2.According to the UACR,the Diabetes patients were divided into the urinary albumin normal group(group N,UACR < 30 mg/g),microalbuminuria group(group A,30 mg/g ? UACR < 300 mg/g)and macroalbuminuria group(group B,UACR ? 300 mg/g).The baseline materials and laboratory indexes were compared among the three groups.Spearman correlation analysis was carried out on the indicators related to UACR,and then the multiple linear stepwise regression analysis of UACR and related indicators was carried out to clarify the relationship.3.With the mean value of 2h PG-FBG(10.53mmol/L)as the boundary value,the Diabetes patients were divided into the low fluctuation of blood glucose group(2h PG-FBG?10.53mmol/L)and the high fluctuation of blood glucose group(2h PG-FBG>10.53mmol/L),comparing the baseline materials and laboratory indexes between the two groups.Spearman correlation analysis and Binary Logistic regression were carried out on the indicators related to 2h PG-FBG.Results: 1.Factors of Age,BMI,course of disease,Hb A1 c,2h PG,2h PG-FBG,fasting c-peptide,and 2 hours c-peptide were significantly diff erent in the normal proteinuria group,microalbuminuria group and macr oalbuminuria group(all P < 0.05).Spearman correlation analysis of UA CR related indicators showed that UACR was negatively correlated withBMI(r=-0.290)and fasting c-peptide(r=-0.246),while UACR was posit ively correlated with Hb A1c(r=0.294)and 2h PG-FBG(r=0.516)(all P<0.05),and the correlation was statistically significant.Multivariate regressi on analysis of UACR showed that 2h PG-FBG was a risk factor for UA CR.2.Age BMI Hb A1 c fasting c-peptide UACR GFR were different b etween the low fluctuation of blood glucose group and the high fluctu ation of blood glucose group(all P<0.05).Spearman correlation analysis was conducted on the indicators related to 2h PG-FBG,showing that 2h PG-FBG was positively correlated with age(r=0.032)Hb A1c(r=0.184)a nd UACR(r=0.516),while 2h PG-FBG was negatively correlated with B MI(r=-0.317)fasting c-peptide(r=-0.437)and GFR(r=-0.364)(all P<0.05).Binary Logistic regression showed that age(OR=1.037)BMI(OR=0.878)Hb A1c(OR=1.398)fasting c-peptide(OR=0.563)UACR(OR=1.005)w ere independently correlated with 2h PG-FBG.Conclusions:1.Postprandial blood glucose fluctuation,represented by blood glucose increment 2 hours after glucose load,was the important factor leading to increased urinary albumin in patients with type 2 diabetes,and the effect was more pronounced than sustained glucose level.2.Age,BMI,Hb A1 c,and c-peptide level had an effect on blood glucose increment 2 hours after glucose load.