Diagnostic Value Of UmAlb/UCYC Ratio In Early DKD And Its TCM Syndromes

Background:Diabetic kidney disease is one of the main chronic microvascular complications of diabetes,at present has become an important cause of end-stage kidney disease.Once reached end-stage kidney disease,the treatment will be more difficult,according to research,urinary cystatin c can reflect the renal tubular function during the early kidney disease,so it can provide new ideas for the early diagnosis of diabetic kidney disease.Objective:By studying the difference of urinary microalbumin/cystatin C ratio(UmAlb/UCYC)in T2DM patients with different proteinuria,the diagnostic value of UmAlb/UCYC ratio for renal tubular injury in early DKD and the distribution characteristics of TCM symptoms in early DKD patients were analyzed.Methods:A total of 180 patients who met the inclusion criteria for T2DM and were treated in Jiangsu Hospital of Traditional Chinese Medicine from September 2019 to December 2020 were collected and divided into 3 groups according to the level of proteinuria:T2DM group(Group A)has 65 patients,Group B has 67 patients and 48 patients(Group C)of clinical DKD.Collect the basic information of the patients(Name,Gender,Age,BMI,Blood pressure,etc.),TCM symptoms,Biochemical indicators(UACR,UCYC,α1-MG,α2-MG,FBG,2hPBG,SCr,BUN,etc.),UmAlb/UCYC ratio level of statistics.Results:(1)There were no statistically significant differences in general data and glucose and lipid metabolism levels among the three groups(P>0.05).(2)Renal function levels in the three groups:SCr,SCYC,UCYC and UmAlb in the early DKD group were higher than T2DM group.The order of UmAlb/UCYC ratio from high to low in the three groups was as follows:Group C>Group B>Group A,the difference was statistically significant(P<0.05);Immune function:There were statistically significant differences in IgG and complement C3 levels among the three groups(P<0.05).(3)Correlation analysis:UmAlb/UCYC ratio in early DKD group was positively correlated with BUN,SCr,blood RBP,urine RBP and α1-Mg(P<0.05).Multiple linear regression analysis indicated that the UmAlb/UCYC ratio was an independent influencing factor of diabetic kidney disease(P<0.05).(4)ROC curve:The sensitivity and specificity of UmAlb/UCYC in the diagnosis of early diabetic nephropathy were 77.61%,75.38%and 0.8357,respectively.(5)The simple T2DM group was mainly characterized by Yin deficiency and dry heat syndrome,while the early DKD patients were mainly characterized by Yin deficiency and dry heat syndrome combined with blood stasis syndrome.(6)Two groups of UmAlb/UCYC ratio are positively correlated with the BUN and SCr,Yin scorching and blood stasis syndrome group,UmAlb/UCYC ratio is a positive correlation with α2-MG and IgA.Conclusion:(1)The T2DM patients was mainly Yin deficiency and dry heat syndrome,while the early DKD patients was mainly Yin deficiency and dry heat syndrome combined with blood stasis syndrome.(2)UmAlb/UCYC ratio has certain value in the diagnosis of early renal function injury.It also can be used as an auxiliary indicator for the diagnosis of early DKD.