Study On The Relationship Between Homocysteine、Lipoprotein(A) And Diabetic Nephropathy With Syndrome Differentiation Of TCM

Objuctive:To investigate the relationship between Homocysteine、 Lipoprotein(a) and Diabetic Nephropathy(DN), in order to early diagnose, prevent and treat DN.In the other hand,to expore the correlation between Homocysteine, Lipoprotein(a) and syndrome differentiation of TCM in DN patients,which may be provide some reference for syndrome differention of DN.Methods:According to the diagnostic criteria,we select60DN patients from department of endocrine in Jiangsu Pro vice Chinese medicine hospital.They were divided into early DN group(30cases) and clinical DN group(30cases).There also be non-DN group(30cases).We collect information of them,including:Hcy、Lp (a)、 FBG. TC、TG、LDL. HLD, mAlb/cr、 UTP in urine.According to symptoms、 signs、 coating on the tongue and pulse,we divide60DN patients into yin asthenia and dryness-heat group(19cases). qi-yin deficiency group(14cases)、 qi deficiency of spleen and kidney group(16cases)、 yin-yang deficiency group(11cases).Compare the level of Hey、 Lp (a) in the different groups and syndromes.Results:The date was analysed by SPSS15.0statistic software.Before the contrast,there is no difference in the age and sex of90cases.①The three groups don’t show difference in smoking history、 genetic history、 BMI,but show highly significant difference in the history of hypertension、 years of disease(P<0.01).②The three groups don’t show difference in diastolic pressure、 FBG. HbAlc、 HDL, but show highly significant difference in systolic pressure、 TG(P＜0.0l), significant difference in TC\LDL(P<0.05).③The three groups show highly significant difference in Hcy(p<0.01), significant difference in Lp (a)(P<0.05).④There is separately linear relationship between Hey and systolic pressure、mAlb/cr、24hUTP(P<0.05).Meanwhile,Lp (a) and systolic pressure、 TC、 LDL、 mAlb/cr、24hUTP(P<0.05).The results of different syndromes①The patients in yin asthenia and dryness-heat syndrome and qi-yin deficiency syndrome are the most in early DN group.The patients in qi deficiency of spleen and kidney syndrome and yin-yang deficiency syndrome are the most in clinical group.②Hcy is the highest in yin asthenia and dryness-heat group,and there is significant difference with Qi-yin deficiency group(P<0.05).Lp (a) is the highest in yin-yang deficiency group.There is significant difference between Qi-yin difference with the other groups(P<0.05).③The level of mAlb/cr is the highest in yin-yang deficiency group.The difference among yin asthenia and dryness-heat group and yin-yang deficiency group、 Qi-yin deficiency group and Qi deficiency of spleen and kidney group、yin-yang deficiency is significant(P<0.05).④24hUTP is the highest in yin-yang deficiency group.There is significant difference between yin-yang deficiency group and other groups(P<0.05), Qi-yin deficiency group and Qi deficiency of spleen and kidney group(P<0.05).No difference in the other groups.Conclusion:①The years of disease、TC、TG、LDL may be the risk factors in the process of DN.②Hcy、Lp (a) may have effect of pathopoiesis to DN. The index of them may be used in the earlier diagnosis and to evaluate pathogenetic condition and to estimate prognosis.③There is some relationship between Lp (a) and the syndrome differentiation of TCM.The results provide an objective、standardize reference for syndrome diffenentiation.