于琦+孙宇琦+刘婵娟

[摘要] 目的 探讨血浆NT-proBNP对糖调节受损人群糖尿病发病的影响。 方法 选取本院门诊体检为糖调节受损患者168例，根据NT-proBNP含量将患者分为高NT-proBNP含量组和低NT-proBNP含量组，比较两组患者的临床资料，确定影响糖调节受损患者NT-proBNP含量变化的相关影响因素和独立影响因素，分析NT-proBNP含量与糖尿病发病的相关性。 结果 通过单因素分析，年龄分布、BMI指数、LDL-C、空腹血糖含量、空腹胰岛素含量均为糖调节受损患者NT-proBNP含量变化的相关影响因素；多因素分析确定，BMI指数、LDL-C、空腹血糖含量、空腹胰岛素含量均为糖调节受损患者NT-proBNP含量变化的独立影响因素；随访3年后，共69例患者发展成糖尿病患者，高NT-proBNP含量组26例，低NT-proBNP含量组43例，差异具有统计学意义（t=7.766，P<0.05）。糖调节受损患者发展成糖尿病与患者NT-proBNP含量具有显著负相关性（r2=0.547，P<0.05）。 结论 糖调节受损患者发展成糖尿病與患者NT-proBNP含量具有显著负相关性，对于合并影响NT-proBNP含量的危险因素的患者及时给予临床干预，尽量降低糖受损人群发展为糖尿病。

[关键词] NT-proBNP；糖调节受损；糖尿病；影响因素

[中图分类号] R587.2；R542.22 [文献标识码] A [文章编号] 2095-0616（2017）13-26-04

[Abstract] Objective To investigate the effect of patients with impaired glucose regulation developed into diabetes mellitus on the plasma NT-proBNP. Methods 168 patients with impaired glucose regulation outpatient physical examination in our hospital were divided into high NT-proBNP group and low NT-proBNP group according to the NT-proBNP content.The clinical data of the two groups were compared to determine the related influence factors and independent influence factors of changes of NT-proBNP content in the patients with impaired glucose regulation.The correlation between NT-proBNP content and the incidence of diabetes mellitus was analyzed. Results Through single factor analysis， age distribution，BMI index，LDL-C，fasting blood glucose content，fasting insulin content were related factors influencing the changes of NT-proBNP content in patients with impaired glucose regulation.Multivariate analysis confirmed that the BMI index，LDL-C，fasting blood glucose，fasting insulin content were independent factors influencing the changes of NT-proBNP content in patients with impaired glucose regulation.After 3 years of follow-up，a total of 69 patients developed into diabetes mellitus，26 cases with high NT-proBNP content，43 cases with low NT-proBNP content，the difference between the two groups was statistically significant （t=7.766，P=0.005）.The development of diabetes and patients with impaired NT-proBNP content had a significant negative correlation of glucose regulation （r=0.547，P=0.000）. Conclusion Patients with impaired glucose regulation have a significant negative association with NT-proBNP levels in patients with diabetes mellitus.In combination with risk factors affecting NT-proBNP levels，patients should be given timely clinical interventions to minimize impaired glucose and develop diabetes.

[Key words] NT-proBNP；Impaired glucose regulation；Diabetes mellitus；Influencing factors

氨基末端前脑钠尿肽（NT-proBNP）是由心肌细胞产生的proBNP后经过蛋白酶裂解产生的。由于其在体内的半衰期较长，而且在体外较稳定，给检测带来方便，在临床检检测治疗中具有重要作用[1-2]。有研究[3-4]证实在给予相同热量的情况下，BNP转基因大鼠脂肪堆积较少，体重增加较少。也有研究证实[5]，BNP含量较低的患者罹患糖尿病的概率提升。但是采用NT-proBNP作为预测糖尿病指标的研究较少[6]。本研究探讨血浆NT-proBNP对糖调节受损人群糖尿病发病的影响，为临床有效的预防糖尿病的发生提供新的思路。

1 资料与方法

1.1 一般资料

选取2013年1～7月在本院门诊体检为糖调节受损患者168例，其中男81例，女87例……