The Analysis Of Risk Factors Of Type 2 Diabetic Nephropathy

Objective: Diabetic nephropathy(DN) is the most common and diabetes have greater dangers of microvascular complications in patients with pathological changes of glomerular sclerosis, and eventually develop into end-stage renal disease. Currently on DN pathogenesis is unclear, but studies generally agreed with lipid disorders, hemodynamic changes and micro-organism joint inflammation and other factors related to the role. This study will explore the risk factors involved in diabetes and diabetic nephropathy, is intended to provide guidance for the prevention and treatment of early DN.Methods: 68 patients with type 2 diabetes mellitus(T2DM) patients and 60 cases of urinary albumin excretion rate(UAER) diagnosed as diabetic nephropathy(DN) patients were investigated from January 2013 to December 2014, and 50 healthy subjects were selected(NC group) for the control group of patients to investigate the contents include: demographic characteristics, disease and diabetic nephropathy sugar disease knowledge, family history, lifestyle(including smoking, alcohol consumption, exercise, sleep), psychosocial factors(stress, personality features). All patients and physical measurements: height, weight, body mass index, waist circumference, blood pressure, body fat ratio. And extracting vein blood of patients, albumin, glucose, lipids, glycated hemoglobin, C peptide, OGTT test, insulin and renal function were detected,and in accordance with the patient signs, symptoms were recorded. Statistical analysis was performed using SPSS19.0, measurement data using the 2 groups(± s) that the groups measurement data using t test, count data using the rate that the groups count data χ2 test was used to compare rates, P <0.05 statistically significance.Results:(1) survey results: the proportion of patients with DN-smoking group, the proportion of family history of diabetes, cardiovascular disease was significantly higher than the proportion of DM group and the control group(P<0.05). DN group weekly blood glucose testing frequency is lower than DM group and the control group(P<0.05).(2) physical examination: DN group, body mass index(BMI), waist circumference, and systolic blood pressure(SBP) levels were significantly higher in the DM group and control group, duration longer than the control group(P<0.05), the difference was statistically significant(P<0.05).(3) Laboratory tests: DN serum ALB, HDL-C levels were significantly lower than the DM group(P <0.05), while the DN group glycated hemoglobin(Hb Alc), fasting C-peptide(CP), postprandial 2h C peptide( 2h CP), insulin resistance index(HOMA-IR), serum creatinine(Cr), UA, CRP, IL-6, TNF-a levels were significantly higher in the DM group and the control group(P<0.05). DN group, insulin levels, TC, LDL-C levels were significantly higher in the DM group and the control group, the difference was statistically significant(P<0.05).(4) Multivariate analysis: The Logistic regression analysis showed that, TC, LDL-C, SBP, CP, insulin, CRP, IL-6, TNF-a,VA/TA,VA/SA is an independent risk factor of DN.Conclusion: Diabetic nephropathy has a close relationship with TC, LDL-C, SBP, CP, insulin, CRP, IL-6, TNF-a,VA/TA,VA/SA and other factors. Clinical diabetes by controlling blood lipids, blood pressure and improve insulin function, thus improving the patient’s condition, prevent and delay the occurrence of DN, reduce the risk of death in patients with DN.