【摘要】 目的 探讨2型糖尿病肾病(DN)的危险因素。方法 采用以医院为基础的配对病例对照研究方法，以年龄和性别为配比条件，对101对研究对象进行了研究。通过问卷调查，体格检查获得研究对象的有关资料。应用聚合酶链反应(PCR)及琼脂糖凝胶电泳方法进行ACE基因多态性分析。结果 调整可能的混杂因素的作用后，条件Logistic回归分析结果表明：ACE基因插入/缺失(I/D)多态性、糖尿病(DM)病程、DM家族史、既往高血压史、患DM后豆类摄入增加等因素是发生DN的危险因素。结论 DN的发生是多因素综合作用的结果。

    【关键词】 糖尿病肾病；危险因素；病例对照研究；条件Logistic回归

    Study on the risk factors of diabetic nephropathy in type 2 diabetic patients

    LI Yong-mei,QI Xiu-ying,CHEN Li-ming.

    Tianjin Medical University,Tianjin 300070,China

    【Abstract】 Objective The aim of this study was to explore the risk factors of diabetic nephropathy(DN) in type 2 diabetic patients.Methods A hospital based case-control study was conducted.101 pairs of subjects were recruited.The cases were considered to be DN patients and the controls were considered by type 2 diabetic patients(DM) without diabetic nephropathy.Each case was matched with one control on sex and age.Information was collected by face-to-face interview and examination,which included demographic data,disease history,disease family history,dietetic habit,behavior pattern,social psychologic character,clinical data and laboratory data.I/D polymorphism of ACE gene was assessed by polymerase chain reaction(PCR) and the PCR products were subjected to electrophoresis on agarose gel that was stained with ethidium bromide.Using the conditional logistic regression modle,we examined the effect of the collected factors on the risk of the diabetic nephropathy development.Results After adjusting for some confounding factors,the results of conditional logistic regression showed that D allele of ACE gene,long diabetes duration,history of hypertension,diabetic family history and increased legume intake were associated with higher risk for the development of diabetic nephropathy.The corresponding OR with 95% CI were 1.820(1.255～2.639),1.907(1.399～2.601),2.055(1.170～3.610),2.000(1.097～3.644) and 1.359(1.010～1.828) respectively.No associations were observed between the following factors and DN,which were education level,family history of hypertension,family history of coronary heart disease,exercise,smoking,alcohol drinking,tea drinking,meat intake,egg intake,milk intake,fat intake,vegetable intake and sweetmeat intake.Conclusion It was multi-factors that attributed to DN. ......