The Relationship Between Type2Diabetic Nephropathy And Free Fatty Acids

Objective:To study the relationship of free fatty acids（FFA） with type2diabetic nephropathy (DN)．Methods: Selected187cases with type2diabetes (T2DM) patients whichcontained136cases of DN and divided them into four groups according to the24-hour urine microalbumin(24hMAU) excretion. They were normal albuminuriagroup (24hMAU<30mg), trace albuminuria group(30mg≤24hMAU<300mg), mildalbuminuria group (300mg≤24hMAU<2000mg), mass albuminuria group (24hMAU≥2000mg).We measured all cases of age, disease duration, systolic bloodpressure, diastolic blood pressure, mean blood pressure, BMI, FFA, fasting bloodglucose (FBG),glycated hemoglobin (HBA1c), blood urea nitrogen (BUN), creatinine,uric acid,24-hour urine albumin (24hMAU), urinary α1-microglobulin and estimatedglomerular filtration rate (eGFR).Results:(1) The differences of age, disease duration, systolic blood pressurediastolic blood pressure,mean blood pressure, BMI, FBG and HBA1c among the fourgroups were not statistically significant (P>0.05),so the data were comparable.(2) Wedivided all of the subjects into three groups based on the FFA concentration from lowto high and found that the24hMAU, creatinine, uric acid, alpha1-MG graduallyincreased with the rise of FFA concentration while the eGFR decreased with the riseof FFA concentration. And the differences were statistically significance (P<0.05).Then we divided all subjects into four levels of DN from light to heavy basedon various indexes of renal function (such as24hMAU, creatinine, uric acid, BUNand, alpha1-MG, eGFR) and found that FFA concentration gradually increased withthe rise of24hMAU, alpha1-MG and the decrease of eGFR.The differences werestatistically significant (P <0.05);We also found that when creatinine, uric acid andBUN increased within the normal range,the FFA concentration was not obvioushigher.When creatinine, uric acid and BUN elevated above the normal range,the FFA concentration was also significantly higher too and the difference was statisticallysignificant (P <0.05).(3) Correlation analysis showed that FFA was positivelycorrelated with BUN,α1-the MG,24hMAU, creatinine and uric acid (P <005),andnegatively correlated with eGFR (P <0.05).(4) Logistic regression analysis showedthat the FFA was a risk factor for DN.Conclusions: Patients with Type2diabetic nephropathy exists abnormal lipidmetabolism and when the DN condition aggravated, lipid metabolism disordersbecomes increasingly clear. FFA involved in the occurrence and the developmentprocess of type2DN. The increase of FFA concentrations can exacerbate kidneydamage in type2DN patients.The combined examination of FFA and24hMAU isvery important for the early prevention,diagnosis and treatment of diabeticnephropathy.