徐永萍,谢思恋,杨 敏

糖尿病肾病（DKD）是糖尿病主要的微血管并发症及终末期肾病的重要诱因，其全球患病率随糖尿病增长而攀升，严重威胁患者生存质量并加剧医疗负担。微量白蛋白尿作为DKD早期诊断和病情评估的核心指标之一，不仅反映肾小球滤过功能损伤，还与心血管事件风险显著相关，提示其兼具肾脏与全身代谢紊乱的双重预警价值。近年研究聚焦于脂代谢关键分子与DKD微量白蛋白尿的关联机制。载脂蛋白B（ApoB）作为致动脉粥样硬化脂蛋白的核心成分，与低密度脂蛋白协同促进血管损伤；载脂蛋白A1（ApoA1）则通过高密度脂蛋白发挥抗炎及胆固醇逆向转运作用。非酯化脂肪酸（NEFA）水平异常可加剧胰岛素抵抗（IR）和氧化应激，而载脂蛋白E（ApoE）多态性影响脂质代谢与转运效率，可能参与DKD肾小球硬化的病理进程。

DKD；脂代谢紊乱；诊断；治疗；心肾共病

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