Correlation Between Urinary Sodium Excretion And Cardiovascular Risk Factors In Patients With Type 2 Diabetes Mellitus In Hospital

Purpose: To explore the relationship between urinary sodium excretion and cardiovascular risk factors in hospitalized patients with Type 2 diabetes mellitus(T2DM).Method: We selected the inpatients with T2 DM in the Department of Endocrinology,Third Affiliated Hospital of Nanchang University as the research object.According to the inclusion criteria and exclusion criteria,393 patients were included.The blood pressure(BP),height and weight of the patients at admission were recorded,the body mass index(BMI)was calculated,the basic data of the patients and biochemical examination during hospitalization were collected,and the patients were asked about the course of disease and whether they had any history of other diseases.Urine samples were collected in the morning,urine creatinine and urine sodium were detected,and then the 24-hour sodium excretion level was estimated according to Tanaka equation.According to the collected clinical indexes and estimated 24-hour urinary sodium excretion level,the patients were divided into low urinary sodium group(group 1: urinary sodium excretion < 120 mmol/d),medium urinary sodium group(group 2: urinary sodium excretion 120-200mmol/d)and high urinary sodium group(group 3: urinary sodium excretion > 200 mmol/d).SPSS 24.0 was used for statistical analysis to explore the correlation between urinary sodium excretion and cardiovascular risk factors in hospitalized patients with T2 DM.Results: 1.The basic data comparison: there were no statistically significant difference(p > 0.05)among the three group(group1,group 2,group 3)in the age,gender,duration,triglyceride(TG),high-density lipoprotein cholesterol(HDL),low density lipoprotein cholesterol(LDL),fasting blood glucose(FBG),blood glucose 2hours after meal,fasting c-peptide,postprandial 2 hours c-peptide,glycosylated hemoglobin(Hb A1c),glutamic-pyruvic transaminase(ALT),creatinine(Cr),uric acid(UA),and other diseases history.There were significant differences in systolic blood pressure(SBP),diastolic blood pressure(DBP),height,weight,BMI and total cholesterol(TC)level among the three groups(P < 0.05),among which the weight and SBP of Group 3 were significantly higher than those of Group 2 and Group 1(P< 0.05),while Group 2 was significantly higher than Group 1(P < 0.05).2.According to whether TC is ≥ 5.7mmol/L,57 cases in the hypercholesterolemia group and 336 cases in the normal group.The 24-hour urinary sodium excretion in the hypercholesterolemia group was significantly higher than that in the normal group,and the difference was statistically significant(177.62±45.81 mmol/L vs.162.15±37.28 mmol/L;p = 0.08).According to whether BMI ≥24kg/m2,the group was divided into the overweight or obese group(n=223)and the normal group(n=170).The results showed that the 24-hour urinary sodium excretion in the overweight or obesity group was significantly higher than that in the normal group,and the difference was statistically significant(167.85±37.65 mmol/L vs.159.86±40.25 mmol/L;p = 0.044).The patients with or without hypertension were divided the hypertension group(n=213)and the normal group(n=180).The results showed that the 24-hour urinary sodium excretion in the hypertension group was significantly higher than that in the normal group,and the difference was statistically significant(170.49±38.18 mmol/L vs.157.18±38.72 mmol/L;p=0.001).3.Taking each factor as independent variable,group 2(medium urinary sodium group)and group 3(high urinary sodium group)as dependent variable,and group1(low urinary sodium group)as control group,multivariate logistic regression analysis showed that SBP was independently correlated with 24-hour urinary sodium excretion compared with low sodium group {OR 1.034(1.008-1.06)p = 0.009}.Compared with low sodium group,SBP was independently correlated with 24-hour urinary sodium excretion {OR 1.066(1.036-1.097)p = 0}.Compared with the low sodium group,the TC in the high sodium group was independently correlated with the 24-hour urinary sodium excretion {OR 1.478(1.003-2.178)p = 0.048}.Conclusion: 1.The 24-hour urinary sodium excretion of inpatients with T2 DM is generally high;2.The 24-hour urinary sodium excretion of inpatients with T2 DM was significantly correlated with SBP,DBP,body weight,BMI,and TC;3.SBP and TC were independently associated with 24-hour urinary sodium excretion of inpatients with T2 DM.