关键词: 肾病综合征,类固醇糖尿病,糖尿病

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the incidence and risk factors of conversion to diabetes mellitus (DM) in primary nephrotic syndrome (PNS) patients with steroid diabetes mellitus (SDM) after withdrawal of glucocorticoid (GC).
Ｍｅｔｈｏｄｏｌｏｇｙ：All SDM patients were divided into diabetes mellitus (DM) group and non diabetes mellitus(NDM) group according to glucose metabolism after stopping GC treatment. The clinical, pathological and laboratory data of the two groups were compared. Logistic regression analysis was used to analyze the risk factors of DM.
Ｒｅｓｕｌｔｓ：Among 220 SDM patients with PNS, 58 (264％) of them converted to DM.The positive family history of diabetes, the later detection of hyperglucemia,hypercholesterolemia, and the high ratio of triglyceride (TG) to high density lipoprotein cholesterol (HDLC) were significantly higher in DM group. There were no difference in the median initral does of GC, the cumulative dose and the median total course of treatment between the two groups. The recurrence of proteinuria in DM group was higher after withdrawal of GC. Multivariate regression analysis showed that positive family history of diabetes, hypercholesterolemia and high TG／HDLC ratio were independent risk factors for the conversion of SDM patients to DM after discontinuation of GC.
Ｃｏｎｃｌｕｓｉｏｎ：The disorder of glucose metabolism could not be reversed in 264％ of PNS patients with SDM after discontinuation of GC. PNS with positive family history of diabetes and prominent dyslipidemia should be carefully decided before GC therapy.

Key words: nephrotic syndrome, steroid diabetes mellitus, diabetes mellitus