首页|期刊导航|中华医学杂志（英文版）|Relationship of plasma creatinine and lactic acid in type 2 diabetic patients without renal dysfunction
中华医学杂志（英文版）Issue(21)：2547-2553,7.DOI:10.3760/cma.j.issn.0366-6999.2009.21.005
Relationship of plasma creatinine and lactic acid in type 2 diabetic patients without renal dysfunction
Relationship of plasma creatinine and lactic acid in type 2 diabetic patients without renal dysfunction
摘要
Abstract
Background As one of most widely-used biguanides,metformin can induce the lactic acidosis in patients with renal failure though its incidence is very low.However,lactic acidemia induced by mefformin was reported in patients without renal dysfunction.It is unclear that whether lactatemia exists in diabetic patients with normal renal function in Chinese or not and its influencing factors.This study aimed to clarify the influencing factors of lactic acid,and identify a practiced clinical marker to predict the hyperlactacidemia in diabetics with normal renal function.Methods The clinical data and venous blood samples of 1024 type 2 diabetic patients treated with(n=426)or without metformin(n=599)were collected.The lactic acid was assayed by enzyme-electrode method.The biochemical indexes included creatinine(Cr)and hepatase were measured with enzymatic procedures.The lactic acid concentrations of different Cr subgroups were compared,and the correlation and receiver operating characteristic curve analysis were used.Results The mean lactic acid level and the proportion of hyperlactatemia of metformin group were significantly higher than that of non-metformin group(P＜0.01),but no lactic acidosis was found in all patients.The correlation and multiple stepwise regression analysis indicated that the correlative factors of lactic acid in turn were Cr,metformin,alanine transferase(ALT),body mass index(BMI),Urine albumin(Ualb),and blood urea nitrogen(BUN)in total patients;and Cr,ALT,BMI and BUN in non-metformin treated patients;Cr and ALT in metformin-group.The lactate concentration increased with the increment of Cr levels,and reached its peak at Cr 111-130 μmol/L,and the optimal cutoff of Cr in predicting hyperlactacidemia was 96.5 μmol/L.Conclusions Metformin can increase the incidence of lactatemia in type 2 diabetic patients without renal dysfunction.Cr,ALT,and BMI are independent associated factors of blood lactic acid levels.There is low proportion of lactatemia in type 2 diabetics without metformin therapy,the optimal cutoff of Cr to predict lactatemia in these patients is 96.5 μmol/L.关键词
diabetes mellitus/lactic acid/creatinine/metformin/cutoffKey words
diabetes mellitus/lactic acid/creatinine/metformin/cutoff分类
医药卫生引用本文复制引用
LIU Fang,LU Jun-xi,TANG Jun-ling,LI Li,LU Hui-juan,HOU Xu-hong,JIA Wei-ping,XIANG Kun-san..Relationship of plasma creatinine and lactic acid in type 2 diabetic patients without renal dysfunction[J].中华医学杂志（英文版）,2009,(21):2547-2553,7.基金项目
This article was supported by a grant from the Major Program of Shanghai Science and Technology Committee(No.04DZ19501). （No.04DZ19501）
