Risk Factors Of Diabetic Nephropathy In Patients With Type 2 Diabetes

BackgroundDiabetes mellitus (DM) is the third chronic non infectious diseases that it serious harms to human health after tumor, cardiovascular disease. At present, the diabetes seriously affects social public health problems in various countries. Diabetes is a lifelong metabolic disorder disease. The incidence of this disease has increased gradually. Diabetic nephropathy (diabetic nephropathy, DN) is the most common complications of diabetes. It is also increasing year by year. Diabetes has become the first cause that caused by chronic kidney disease (CKD) in the developed country and the developing country. Diabetic nephropathy is a common complication of diabetes mellitus, is the main cause of death in type 1 diabetes mellitus, also is the second cause of death in type 2 diabetes mellitus.The pathogenesis of diabetic nephropathy is complex, its risk factors is not very clear. The present study demonstrates that systolic blood pressure, diabetes duration and total cholesterol are the independent risk factors of diabetic nephropathy, age, diastolic blood pressure, hypertension, coronary heart disease history, diabetes eye disease and diabetic peripheral neuropathy are the relative risk factors of diabetic nephropathy.ObjectivesIn this paper, I hope to provide some help to the clinical prevention and treatment of diabetic nephropathy through the analysis of observation of the relevant risk factors of diabetic patients with diabetic nephropathy.Methods1. Study samples:432 cases with type 2 diabets admitted into the General Hospital of Hebi Coal Group from January 2010 to December 2013 were included in this study.2. Clinical materials:The patient’s name, gender, age, blood pressure, height, weight, waist circumference, hip circumference of each patient were recorded. Body mass index(BMI)=body weight(kg)/body height2(m2). Diabetie course, family history of diabetes, history of hypertension and ischemic heart disease were recorded-. History of smoking, drinking, fatty liver and cholecystolithiasis were also collected. Blood samples was drawn from the ulnar vein in the morning when patients were in resting state after food and drink forbidden for 8-10 hours, and were used to measure fasting blood glueose(FPG),2-hour postprandial glucose(2hPG), glycosylated hemoglobin (HbAlc), triglyeeride(TG), totoleholesterol(TC), andereatinine(CREA), bloodurea nitrogen(BUN). Measure urine routine and urine sanguinis mieroalbumin, collect 24 hour urine for quantitative assay of protein.3. Groups:4 Groups are divided according to MAUand GFR. There were diabetes mellitus with normal albuminuria (A group), diabetic nephropathy with microalbuminuria(B group), diabetic nephropathy with over proteinuria(C group), end-stage diabetic nephropathy(D group).4. Statistical Analyses:The datas were analyzed by SPSS softwate Version 19.0, including T-tests, ANOVA, non-parametric test and logistic regression. P values<0.05 was considered statistically significant.Results1. Normal albuminuria group was 47.9%, Microalbuminuria group was 23.6%, clinical albuminuria group was 19%, end-stage renal disease group was 9.7% in the 432 patients with type 2 diabetes mellitus.2. Gender, family history of diabetes, smoking, drinking, diabetes foot and cerebral vascular lesions were not statistically significant in the 4 groups. Age, course of disease, systolic pressure, diastolic pressure, coronary heart disease, diabetic eye disease and peripheral nerve lesions were statistically significant in the 4 groups. Data became higher gradually from normal albuminuria group to end-stage group.3. The systolic pressure and the diastolic pressure of the patients with DN (B.C and D groups) were significant higher than the patients A group(P<0.05). The systolic pressure and the diastolic pressure of C and D groups were significant higher than the patients B group (P<0.05). Multivariate logistic regression analysis showed that the systolic blood pressure was associated with the incidence of DN (P<0.001).4. The FPG and the HbAlc had significant difference between B group and the A group (P<0.05). The FPG had significant difference between C group and the A group (P<0.05). The FPG and the HbAlc had not significant difference between D group and the A group. Multivariate logistic regression analysis showed that FPG and HbAlc were related with DN. UA of the patients with DN (B,C and D groups) were significant higher than A group(P<0.05).5. TG and TC became higher gradually from normal albuminuria group to over proteinuria group,data of end-stage diabetic nephropathy group was the lowest of the four groups, differences had statistieal significance.6..Non-eondition logistic regression results:Systolic blood pressure, diabetic course and total cholesterol were the independent risk fators to diabetie nephropathy. Diabetic ophthalmology and family history of diabetes were also independent risk factors to early metaphase of diabetic nephropathy. Systolic blood pressure and diabetic course were the independent risk fators to end-stage diabetie nephropathy.ConclusionsHypertension, genetic, long-term high blood glucose and lipid metabolism disorder are result in the development and progression ofdiabetie nephropathy, and are closely associated with complications. Diabetic nephropathy requires comprehensive treatment. Comprehensive periodic inspection, strict control of blood pressure, blood glucose and blood lipids are contributed to the prevention ofdiabetie nephropathy.