Abstract: Objective　To explore the correlations of blood glucose fluctuation with renal function and oxidative stress in patients with type 2 diabetes nephropathy. Methods　Eighty-two patients with type 2 diabetes treated at Jinan Second People's Hospital from January 2019 to January 2022 were divided into a simple type 2 diabetes group (28 cases) and a type 2 diabetes nephropathy group (54 cases); 17 healthy people were selected as a healthy group. The clinical data were collected and compared. In the simple type 2 diabetes group, there were 14 males and 14 females who were 31-68 (49.52±8.52) years old, with 5 smokers. In type 2 diabetes nephropathy group, there were 33 males and 21 females who were 30-70 (50.52±8.61) years old, with 3 smokers. In the healthy group, there were 10 males and 7 females who were 30-80 (52.52±8.77) years old, with 3 smokers. The 24 h mean blood glucose standard deviations and mean blood glucose fluctuation ranges of the three groups were compared. The blood urea nitrogen (BUN) and creatinine (SCr) were measured by the automatic biochemical analyzer. The levels of reactive oxygen species (ROS) and superoxide dismutase (SOD) of the three groups were compared. t and χ² tests and one-way ANOVA were applied. The Pearson method was used to analyze the correlations of blood glucose fluctuation with renal function and oxidative stress in the patients with type 2 diabetes nephropathy. Results　The 24 h mean blood glucose standard deviations and the mean blood glucose fluctuation ranges in the simple type 2 diabetes group and the type 2 diabetes nephropathy group were higher those in the healthy group (F=26.446 and, 49.198, both P<0.001), and those in the type 2 diabetes nephropathy group were higher than those in the simple type 2 diabetes group, with statistical significance (both P<0.05). The BUN and SCR in the simple type 2 diabetes group and the type 2 diabetes nephropathy group were lower than those in the healthy group (F=17.541 and 16.524, both P<0.001), and those in the type 2 diabetes nephropathy group were lower than those in the simple type 2 diabetes group (both P<0.05). The ROS and SOD in the simple type 2 diabetes group and the type 2 diabetes nephropathy group were lower than those in the healthy group (F=21.250 and 18.522, both P<0.001), and the levels in the type 2 diabetes nephropathy group were lower than those in the simple type 2 diabetes group (both P<0.05). Pearson's results showed that BUN, SCR, ROS, and SOD were negatively correlated with the mean blood glucose fluctuation of the patients with type 2 diabetes nephropathy (r=-0.365, -0.687, -0.854, and -0.257; P= 0.012, 0.021, 0.015, and 0.010). Conclusion　There are negative correlations of blood glucose fluctuation with renal function and oxidative stress in patients with type 2 diabetes nephropathy.

Key words: Type 2 diabetes nephropathy, Renal function, Blood urea nitrogen, Creatinine, Oxidative stress, Reactive oxygen species, Superoxide dismutase

摘要： 目的　探讨2型糖尿病肾病患者血糖波动与肾功能和氧化应激的相关性分析。方法　选取2019年1月至2022年1月济南市第二人民医院收治的2型糖尿病患者82例，其中单纯2型糖尿病28例（单纯2型糖尿病组）、2型糖尿病肾病54例（2型糖尿病肾病组），另选取17例健康者为健康组。单纯2型糖尿病组患者中，男14例，女14例，年龄31~68（49.52±8.52）岁，吸烟5例；2型糖尿病肾病组患者中，男33例，女21例，年龄30~70（50.52±8.61）岁，吸烟3例；健康组中男10例，女7例，年龄30~80（52.52±8.77）岁，吸烟3例；收集研究对象的临床资料，比较3组研究对象的血糖波动指标（24 h平均血糖标准差、平均血糖波动幅度），采用全自动生化分析仪测定肾功能尿素氮（BUN）、肌酐（SCr），比较3组患者氧化应激活性氧（ROS）、超氧化物歧化酶（SOD）水平。采用t、χ²检验和单因素方差分析，采用Pearson法分析2型糖尿病肾病患者血糖波动与肾功能和氧化应激的相关性。结果　与健康组相比，单纯2型糖尿病组、2型糖尿病肾病组患者24 h平均血糖标准差、平均血糖波动幅较高（F=26.446、49.198，均P<0.001），2型糖尿病肾病组高于单纯2型糖尿病组，两组比较差异有统计学意义（均P<0.05）。与健康组相比，单纯2型糖尿病组、2型糖尿病肾病组患者BUN、SCr较低（F=17.541、16.524，均P<0.001），2型糖尿病肾病组低于单纯2型糖尿病组（均P<0.05）。与健康组相比，单纯2型糖尿病组、2型糖尿病肾病组患者ROS、SOD较低（F=21.250、18.522，均P<0.001），2型糖尿病肾病组低于单纯2型糖尿病组（均P<0.05）。Pearson结果显示，BUN、SCr、ROS、SOD与2型糖尿病肾病平均血糖波动幅度呈负相关（r=-0.365、-0.687、-0.854、-0.257，P=0.012、0.021、0.015、0.010）。结论　2型糖尿病肾病患者血糖波动与肾功能和氧化应激呈现负相关。

关键词: 2型糖尿病, 肾功能, 尿素氮, 肌酐, 氧化应激, 活性氧, 超氧化物歧化酶