The Predictive Value Of Visceral Fat Index And Lipid Accumulation Index For Microalbuminuria In Newly Diagnosed Type 2 Diabetes Patients

Objective:In recent years,the prevalence of type 2 diabetes mellitus(T2DM)in China has been increasing year by year,and cardiovascular disease and kidney disease are the important complications of diabetes.Microalbuminuria(MAU)is an important marker of early renal damage and cardiovascular injury in diabetic patients.The occurrence of MAU is still in the early stage of the disease.Without early intervention,MAU will progress to the stage of massive proteinuria,and the disease will be irreversible and seriously affect the quality of life of patients.Therefore,early detection and early intervention in the occurrence of MAU is particularly important.Obesity,especially visceral obesity,is a risk factor for MAU in diabetic patients.Visceral adiposity index(VAI)and lipid accumulation index(LAP)are useful indicators for evaluating visceral fat content.Therefore,the present study investigated the predictive value of VAI and LAP in the occurrence of MAU in newly diagnosed T2DM patients.Methods:A retrospective study was conducted on T2DM patients hospitalized in our hospital from January 2018 to September 2020.According to the inclusion and exclusion criteria,335 patients were included in the study,including 226 males(group A)and 109 females(group B).According to the occurrence of MAU,the male group was divided into A1 group and A2group,and the female group was divided into B1 group and B2 group.Clinical data of patients were collected and LAP and VAI were calculated.Clinical date were collected,such as height,weight,waist circumference,hip circumference,smoking history,drinking history,blood pressure,blood sugar,blood fat,glomerular filtration rate,24-hour urinary microalbumin total,ect.BMI,waist-to-hip ratio,insulin resistance index,LAP and VAI were calculated according to the above indicators.The t test was used for the comparison between groups of measurement data with normal distribution,and the Mann Whitney U test was used for the comparison between groups of measurement data with skewed distribution.χ~2test was used for comparison between groups.Binary Logistic regression was used to analyze the risk factors affecting MAU,and Receiver Operating Characteristic Curve(ROC)and area under the cure(AUC)were established to analyze the predictive value of each index on MAU.Results:1.General data:Among the male patients,the levels of BMI,WC,uric acid,FBG,WHR,TG,HOMA-IR,LAP and VAI in the A1 group were all higher than those in the A2 group,with statistically significant differences(p<0.05).HDL level was lower than that of A2 group,and the difference was statistically significant(p<0.05).Among female patients,the levels of BMI,WC,WHR,FBG,TG,HOMA-IR,LAP and VAI in group B1 were all higher than those in group B2,with statistically significant differences(p<0.05).HDL level was significantly lower than that of B2 group,and the difference was statistically significant(p<0.05).2.Logistic regression analysis of urinary microalbumin influence:Since there was significant collinearity between LAP and VAI,the models of LAP and VAI and patient outcomes were established respectively.In male patients,Logistic multivariate regression analysis indicated that FBG,WC,LAP and VAI were independent influencing factors for the occurrence of MAU in T2DM patients.In female patients,Logistic regression analysis suggested that FBG,WC,LAP and VAI were also independent risk factors for MAU in T2DM patients.3.ROC curve:According to the ROC curve results,the areas under the curves of WC,FBG,LAP and VAI in male patients were 0.626,0.676,0.760and 0.742,respectively.The areas under the curves of WC,FBG,LAP and VAI in female patients were 0.703,0.685,0.787 and 0.764,respectively.Both VAI and LAP have predictive value for the occurrence of MAU in newly diagnosed T2DM patients,and the area under the LAP curve is the largest.In addition,the area under the curve of VAI and LAP was higher in female patients than in male patients.Conclusion:1.FBG,WC,VAI and LAP were independent risk factors for the occurrence of MAU in T2DM.2.Both VAI and LAP have predictive value for the occurrence of MAU in newly diagnosed T2DM patients,among which LAP has the largest area under the curve and the highest diagnostic value.3.In the prediction of MAU occurrence in newly diagnosed T2DM patients,VAI and LAP have higher predictive value in the female group,suggesting that they are more suitable for female patients.