The Clinical Study On The Abnormality Of Blood Lipids And Coagulation In Type 2 Diabetic Nephropathy

ObjectiveTo measure the levels of blood lipids and plasma coagulation parameters in type 2 diabetic nephropathy(DN), and to investigate the relationship of imPaired liPid metabolism and hypercoagulation status with the type 2 diabetic nephropathy. In this study we may be offer some help to earlier diagnosis,prevention,treatment,and postpone the Progression of diabetic NePhroPathy.Methods74 patients with type 2 Diabetic Mellitus(T2DM)(which diagnory standard in order to 1999 WHO diagnostic standards) in our department from Dec.2009 to Aug.2010, without urinary in fection and prmiary nephropathy ,DM duration(10.3士5.5) years,38 male and 36 female,(59.3士8.1) years old. T2DM patients were divided into three groups based on mALB/Scr excretion rate,which include:group A (normal albuminuria group): 26 cases without albuminuria,13 male and 13 female,(59.2±7.7) years old; group B (micro albuminuria group): 21 cases with microalbuminuria, 12 male and 9 female,(59.3±9.8) years old:group C (macroalbuminuria group): 27 cases with macroalbuminuria 13 male and 14 female,(59.8±6.8) years old. After absolute diet for 12 hours venous blood were obtained in the next morning. We measured the levels of low density lipoprotein-cholesterol(LDL-c) , high density lipoprotein-cholesterol(HDL-c) , Total cholesterol(TC), Plasma triglycerides(TG),HbAlc,Fasting plasma glucose(FPG) and plasma prothrombin time(PT), activate part plasma prothrombin time(APTT), prothrombin time(TT) and fibrinogen(Fg) in all cases and 20 cases normal controls. All the statistical analysis were dealt with SPSS 13.0 software.ResultThe DM duration was longer in microalbuminuria group than normal albuminuria group, macroalbuminuria group was longer than microalbuminuria group: Differences of duration among the 3 grouPs were statistieally significant(P<0.05). Fasting plasma glucose, systolic and diastolic blood pressure were higher in microalbuminuria group and macroalbuminuria group than in normal albuminuria group, which were higher in macroalbuminuria group than in microalbuminuria group. There was no statistical signifcance in HbA1c,BMI among 3 groups(P>0.05).The levels of triglyceride, total cholesterol and low density lipid cholesterol were higher in microalbuminuria group and macroalbuminuria group than in normal albuminuria group, which were higher in macroalbuminuria group than in microalbuminuria group. Levels of TG,TC,LDL-c were Positive correlation with mALB/Scr excretion rate (P<0.05) . The change of level of HDL-c in 3 groups had no regularity,so there was no statistical signifcance in high density lipid cholesterol among 3 groups(P>0.05).The level of total cholesterol was the highest and the most important in lipids metabolism. The level of plasma Fg of type 2 diabetic Mellitus had risen significantly than that of the normal controls(P<0.05). group C is higher than group B and group A,group B is higher than group A; The level of APTT,PT had shortened compared with that of the normal controls(P<0.05). group C is shorter than group B and group A,group B is shorter than group A; The level of TT in 3 groups had no statistical signifcance(P>0.05). Levels of APTT,PT were negative correlation with mALB/Scr excretion rate (P<0.05) . The level of plasma Fg was positive correlation with UAER(P<0.05). The level of plasma Fg was the highest and the most important in coagulation function.ConclusionIt is suggesting that the disorder of lipids metabolism and hypercoagulability may play a role in development and progression of diabetic nephropathy in type 2 diabetes. There is close relationship between the metabolic syndrome(MS) and diabetic nephropathy. They are important in diagnosising and evaluating type 2 diabetic nephropathy. The blood lipids and coagulation function disorder have closely correlation in diabetic nephropathy. TC and Fg are the most important in the levels of blood lipids and plasma coagulation parameters .To prevent and delay the development of type 2 DN, we ought to examine the plasma lipids and coagulation parameters in those patients as early as possible.