The Value Of Urinary Albumin-to-creatinirie Ratio In The Early Diagnosis Of Diabetic Kidney Disease And The Association Study Of It With Type2Diabetes

Objective：1、To investigate the value of the urinary albumin creatinine ratio in the early diagnosisof diabetic kidney disease.2、Explore the relationship between urinary albumin-to-creatinine ratio and bloodglucose, blood pressure, BMI, duration of disease, glycosylated hemoglobin and otherclinical factors.Methods：1. According to the diagnostic criteria of type2diabetes, the inclusion criteria andexclusion criteria，collection of293cases of type2diabetes patients from January2005toDecember2011in Endocrinology of our hospital (tertiary medical centers). Including men,153cases,140cases of women. Age (51.53±10.81) years.The clinical data wereretrospectively investigated, including the urinary albumin–to-creatinine ratio (ACR),24hurinary albumin, total cholesterol, triglyceride, high density lipoprotein, low densitylipoprotein, glycated hemoglobin of HbAlc, blood glucose, blood urea nitrogen and serumcreatinine.And age, sex, BMI, blood pressure, diet in general. Stratified according to theurine of patients with ACR levels, glycosylated hemoglobin, duration in respectively. Selecttinghospital examination70cases of healthy individuals as control group, In thisgroup,including37cases of male and33cases of female. Age (51.89±12.34) years. Recordthe above test results and the general situation. Understanding the above test results ofdifferent groups,the relationship between ACR and duration of diabetes, HbAlc, diabeticretinopathy, and the correlation between Urinary albumin/creatinine and24h urinaryalbumin.2. The data obtained were statistically analyzed by t test, χ2test and linear correlationanalysis and other statistical methods. Set P <0.05indicated the difference of statisticallysignificant. Results：1. Compareing Type2diabetic group with the healthy control group, we find the urinealbumin-to-creatinine ratio,24h urinary albumin, total cholesterol, triglyceride, high densitylipoprotein,low-density lipoprotein, glycated hemoglobin, blood glucose, systolic bloodpressure, diastolic blood pressure, blood urea nitrogen and serum creatinine between the twogroups were statistically significant (P <0.05). Urinary albumin-positive and negative groups,duration, BMI, and fasting plasma glucose, systolic blood pressure and TG were higher thanthe urinary albumin-negative group, while the HDL-C is lower than the normal urinaryalbumin group.The difference is statistically significant (P <0.05).2. The correlation analysis is btween morning fasting urine albumin-to-creatinine andurine albumin excretion rate, r＝0.936，P＜0.01.The correlation analysis is btweenmorning fasting urine albumin-to-creatinine and24h urinary albumin to the quantitativevalue, r＝0.906， P＜0.01. And the correlation analysis is between random urinealbumin-to-creatinine and urine albumin excretion rate, r＝0.756，P＜0.01. And thecorrelation analysis is between random urine albumin-to-creatinine and24h urinary albuminquantitative value, r＝0.738，P＜0.01. Fasting and random ACR with UAER and24hurinary albumin as a highly positive correlation.The urinary protein, serum creatinine, bloodurea nitrogen level in subgroup of type2diabetes group,there is no significant difference, P＞0.05. Comparison of serum creatinine, blood urea nitrogen and urine ACR sensitivity forthe diagnosis of diabetic diabetic kidney disease, the urine ACR positive rate wassignificantly higher than the first two indicators, P＜0.01.3. Btween HbAlc <7%group and7%≤HbAlc <8%group, no significant difference inpositive rate of urine ACR,P＞0.05. For the HbAlc>8%group, the urine albumin-positiverate higher than the first two groups, the result is statistical significance, P＜0.05.Duration of diabetes (0-5years), group (5-10years) and group (10years-), the urine ACR positive rateare pairwise comparisons were statistically significant, P＜０.０5.4. Diabetic patient without retinopathy group compared with the healthy control group, there isstatistically significant on the urinary albumin-to-creatinine values and urine ACR positive rate of the twogroups, P＜０.０5. Comparing the diabetic patients without retinopathy,the patient with backgrounddiabetic retinopathy group and the patient with proliferative retinopathy, the urinary albumin levels andurine ACR positive rate are higher than the above two groups,there is statistically significant,P＜０.０5Conclusion：1. Morning fasting microalbumin creatinine ratio and random urine microalbumin creatinine ratio areinto a highly positive correlation with urine albumin excretion rate and24h urine albumin quantitatively. There is no significant difference on fasting and random urinary ACR. The abnormalof urinary ACR is occurred more earlier than blood urea nitrogen, serum creatinine and urine protein.Proved that both of them can be used as sensitive indicators of the early diagnosis of diabetic kidneydisease.2. Through this study can be shown that urinary albumin-positive patients with fasting blood glucose,systolic blood pressure and BMI were higher than the urinary albumin-negative patients with diabetes.While HDL-C lower than urine ACR negative group.3. Duration of diabetes is an independent risk factor during the development of diabetic nephropathy.4. Diabetic retinopathy and diabetic nephropathy coexist in Type2diabetes patients. Studies showthat diabetic nephropathy occurred more earlier than the diabetic retinopathy,and the level of diabeticretinopathy gradually increased with the increase of urinary albumin.