Clinical Research On The Correlation Between MHR And Diabetic Kidney Disease

Objectives:To investigate the correlation between monocyte to high-density lipoprotein cholesterol ratio(MHR)and clinical indicators of diabetic kidney disease(DKD)patients and to analyze the value of MHR for the diagnosis of DKD.Analyze the predictive value of MHR on the risk of all-cause mortality in DKD dialysis patients.Methods:A total of 200 patients with type 2 diabetes mellitus and 200 patients with DKD from the Nephrology and Endocrinology Department of the Second Affiliated hospital from January 2018 to December 2020 were selected.The DKD group was divided into the microproteinuria group(urinary albumin creatinine ratio 30-300 mg/g)and the massive proteinuria group(urinary albumin creatinine ratio>300 mg/g).Besides,200 healthy people with matching sex,age,and body mass index who attended our hospital during the same period were selected as the control group.By collecting and comparing the general information and laboratory test data of each group and comparing their differences between the three groups,multi-factor logistic regression analysis was used to study the influencing factors of DKD.Spearman correlation analysis was used to explore the correlation between MHR and the above indicators.The clinical diagnostic value of MHR for early DKD(urinary albumin creatinine ratio:30-300 mg/g)was analyzed using subject working characteristic curves.Besides,51 hemodialysis patients and 64 peritoneal dialysis patients with end-stage renal disease due to DKD we selected from our center.We recorded clinical baseline information and laboratory test data when the patient starts dialysis from January 2018 to December 2020.The Kaplan-Meier method and Cox regression analysis model were used to analyze the factors affecting dialysis patients’ survival with DKD,The dialysis patients’ data were divided into two groups by the median MHR to compare the risk of all-cause mortality between patients in the high and low MHR groups.Results:(1)MHR was positively correlated with BUN,Scr and HOMA-IR,while it was negatively correlated with ALB,indicating that MHR is associated with renal impairment and malnutrition.(2)MHR,history of cardiovascular disease,and urinaryα1-MG were independent risk factors for early diabetic nephropathy progression,and eGFR and Lp(a)were independent protective factors for early diabetic nephropathy.(3)MHR has some diagnostic value for early DKD,with AUC=0.581,the predictive cut-off value is 0.2941,sensitivity is 76.2%,and specificity is 38.7%.(4)MHR wasn’t an independent risk factor for all-cause mortality in DKD dialysis patients.Still,female DKD dialysis patients with higher MHR(>0.41)levels,and previous cardiovascular disease history were at a relatively higher risk of all-cause mortality.Conclusions:MHR is positively correlated with the severity of kidney damage in diabetic patients.The risk of all-cause mortality was relatively high in DKD dialysis patients with higher MHR levels.