Risk Factors For Diabetic Nephropathy And Their Correlation With TCM Syndrome Type

Objective : Medical records of patients with type 2 diabetes and diabetic nephropathy in the Second Affiliated Hospital of Dalian Medical University were collected,and a retrospective analysis was conducted to study the risk factors which will lead type 2 diabetes to diabetic nephropathy,the relation between the relevant factors and the distribution of traditional Chinese medical syndromes,so that we can provide ideas for the prevention of diabetic nephropathy intervention and provide reference for clinical syndrome differentiation of diabetic nephropathy.Methods : Randomly selected 183 patients who were diagnosed with type 2diabetic nephropathy in the Second Affiliated Hospital of Dalian Medical University from March 2014 to October 2015 as the research object.The 96 cases with diabetic nephropathy were divided into group DN;the left 87 cases not with diabetic nephropathy divided into group NDN.By reference “diagnosis of diabetic nephropathy,syndrome differentiation and evaluation standard” which was developed by Branch of the Chinese Medical Association nephropathy in 2007,we classify all the diabetic nephropathy patients into four TCM syndromes: “yin hot”,“deficiency of qi and yin”,“deficiency of yin in spleen and kidney”,“deficiency of yin and yang”.Collected all patient’s sex,age,duration,body mass index,blood lipid(cholesterol,triglycerides,high density lipoprotein,low density lipoprotein),blood pressure(systolic blood pressure,diastolic blood pressure,pulse pressure),blood glucose(fasting glucose,2h postprandial blood glucose),HbA1 c,fasting insulin,insulin sensitivity index,,Cystatin C,urine albumin / urine creatinine.Analysis the risk factors which will leadtype 2 diabetes to diabetic nephropathy,and explore the relation between the relevant factors and the distribution of traditional Chinese medical syndromes.Analyzed the data through SPSS13.0 statistical analysis software.All of the numerical data were expressed as the sx ?.The significance of differences between groups was analyzed by single-factor analysis of variance.Student’s t-test was used for comparisons between two groups.All of the count data were expressed as a percentage(%),and Chi-square test was used for comparisons between two groups.Logistic regression analysis was used to explore the risk factors.Significance was defined at P <0.05.Result:1.The difference in smoking history,age,disease duration between group DN and group NDN ware statistically significant.(P <0.05).The group DN had more smoking patients,greater age,and longer duration than the group NDN.The difference in drinking history,family history of diabetes,body mass index were not statistically significant(P <0.05).2.The difference in SBP and pulse pressure ware statistically significant(P <0.05).The group DN had higher SBP and bigger pulse pressure than group NDN.Diastolic blood pressure and blood lipid levels between the two groups had no significant difference(P <0.05).3.The fasting glucose,fasting insulin,cystatin C levels in the group DN are all higher than in the group NDN,while the insulin sensitivity index was below.The difference was statistically significant(P <0.05),2h postprandial blood glucose and glycated hemoglobin between the two groups had no significant difference.4.In order to clarify the risk factors associated with the occurrence of DN,the above-mentioned factors associated with the occurrence of DN were logged to the Logistic regression analysis and the result showed that : duration(OR = 1.083,P =0.006),cystatin C(OR = 2.427,P = 0.037),fasting plasma glucose(OR = 1.131,P =0.011),fasting insulin(OR = 1.021,P = 0.044)were the risk factors of diabetic nephropathy.5.Course,cystatin C and urine albumin / creatinine among various syndromes of DN were not exactly equal(P <0.05).The results of pairwise comparison showed thatin terms of the course,both “deficiency of yin in spleen and kidney” and “deficiency of yin and yang” were longer than “yin hot”,and differences were significant.“Yin and Yang deficiency” were higher than the other three TCM syndromes in cystatin C and urinary microalbumin / creatinine.In terms of sex,age,BMI,blood pressure,cholesterol,smoking history,drinking history,family history of diabetes,fasting blood glucose,postprandial 2h blood glucose,glycated hemoglobin,insulin sensitivity index,cystatin C,urine protein / creatinine,there was no significant difference(P> 0.05).Conclusion:1.Age,duration,smoking history,systolic blood pressure,pulse pressure,cystatin C,fasting glucose,fasting insulin,insulin sensitivity index are related to the pathogenesis of diabetic nephropathy.Among the factors above,duration,fasting blood glucose,cystatin C,fasting insulin are the risk factors of diabetic nephropathy.2.TCM Types presence of diabetic nephropathy has some contact with course of disease,cystatin C and urine albumin / creatinine.In terms of the course,both“deficiency of yin in spleen and kidney” and “deficiency of yin and yang” are longer than “yin hot”.“Yin and Yang deficiency” are higher than the other three TCM syndromes in cystatin C and urinary microalbumin / creatinine.Therefore,it shows that “Yin and Yang deficiency” is terminal syndromes of diabetic nephropathy...