| Objective: By detecting the levels of lipoprotein-associated phospholipase A2(LpPLA2)and complement C1 q in serum of diabetic kidney disease(DKD)patients,to explore the correlation between the above indexes and DKD and its application value in the diagnosis of type 2 diabetic kidney disease.Methods: A total of 156 patients with T2 DM who were hospitalized in the Endocrinology Department of Shaanxi Provincial People’s Hospital between October 2019 and December 2021 were selected.According to the level of urinary albumin to creatinine ratio(UACR),the participants were divided into three groups: 71 in normal albuminuria(NA)group and 45 in microalbuminuria(MA)group,there were 40 people in the heavy albuminuria(HA)group.Among them,MA group and HA group belong to DKD group,while NA group belongs to NDKD group.The gender,age,duration of diabetes,height,weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),serum creatinine(SCR),uric acid(UA),retinol binding protein(RBP),Cystatin-C(Cys-C),Lp-PLA2,complement C1 q,UACR,estimate glomerular filtration rate(eGFR),glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG)and other general information and related biochemical indicators,calculate body mass index(BMI)and estimate glomerular filtration rate(eGFR).SPSS 25.0 software was used for data analysis,and P < 0.05 indicated statistically significant difference.Results :(1)Comparison of general data between the three groups: a total of 156 T2 DM patients were included in this study,including 71 in NA group,45 in MA group,and 40 in HA group.There were significant differences in age,course of disease and SBP among the three groups.There was no significant difference in BMI,DBP,TC,TG,HDL-C,LDL-C,Hb A1 c and FBG among the three groups.(2)Comparison of kidney-related indicators among the three groups: there were significant differences in BUN、SCr、UA、RBP、Cys-C、UACR、eGFR、Lp-PLA2、and complement C1 q among the three groups(P < 0.05).(3)Correlation analysis between UACR and various factors: there was a positive correlation between UACR and age,course of disease,SBP,BUN,SCr,UA,RBP,Cys-C,Lp-PLA2,complement C1 q,but a negative correlation with eGFR.(4)Logistic regression analysis of DKD risk factors showed that SBP,SCr,LpPLA2 and complement C1 q were independent influencing factors of DKD,with OR values of 1.061,1.079,1.017 and 1.020,respectively.(5)Receiver operation characteristic(ROC)curve showed that the area under curve(AUC)of Lp-PLA2 single detection was 0.775(P < 0.001),95% CI was 0.701 ～ 0.849,yoden index was 0.525,the best cutoff value was 164.23ng/m L,sensitivity was 83.50%,specificity was 69.00%.The AUC of single detection of complement C1 q was 0.711(P <0.001),95% CI was 0.628 ～ 0.793,yoden index was 0.400,the best cut-off value was178.10mg/L,sensitivity was 68.20%,specificity was 71.80%.The AUC of combined detection of Lp-PLA2 and complement C1 q was 0.794(P < 0.001),95% CI was 0.724 ～0.863,yoden index was 0.464,sensitivity was 78.80%,and specificity was 67.60%.(6)Correlation analysis between Lp-PLA2 and various factors: Lp-PLA2 was positively correlated with TC,TG,LDL-C,SCr,UA,RBP,Cys-C,UACR,Hb A1 c,FBG,and negatively correlated with eGFR.(7)Correlation analysis between complement C1 q and various factors: C1 q was positively correlated with BMI,SBP,TC,TG,UA,RBP,Cys-C,UACR,Hb A1 c and FBG,and negatively correlated with eGFR.Conclusions:(1)Serum Lp-PLA2 and complement C1 q levels increased in DKD patients,Serum Lp-PLA2 and complement C1 q are independent influencing factors of DKD.(2)when serum Lp-PLA2 > 164.23ng/m L and complement C1 q > 178.10mg/L,the risk of DKD will increased.(3)Lp-PLA2 was positively correlated with TC,TG,LDL-C,SCr,UA,RBP,CysC,UACR,Hb A1 c,FBG,and negatively correlated with eGFR.(4)Complement C1 q was positively correlated with BMI,SBP,TC,TG,UA,RBP,Cys-C,UACR,Hb A1 c and FBG,and negatively correlated with eGFR. |
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