Correlation Analysis Of Hcy、HbAlc Levels And Renal Function On Patients With Type 2 Diabetic Nephropathy

Objective:Through testing the serum homocysteine(Hcy)and glycosylated hemoglobin(Hb Alc)levels of patients with type 2 diabetes mellitus and diabetic nephropathy,The aim is to investigate the changes of patients with type 2 diabetic nephropathy,and to understand the correlation between the two factors and renal function in patients with type 2 diabetes mellitus and diabetic nephropathy.Method: Select 136 cases of type 2 diabetes mellitus and diabetic nephropathy patients as the subjects,Which were admitted to Department of nephropathy and Department of endocrinology in First Hospital Affiliated to Lanzhou University from March 2015 to De cember 2015.Blood Hcy,HbAlc,UAER,creatinine,urea nitrogen,24 h urinary protein and estimated glomerular filtration rate(e GFR)were detected in all subjects,These subjects were divided into three groups according to UAER,simple diabetic group(UAER <20 UG / min,n=52),microalbuminuria with nephropathy group(UAER 20 ~ 300 ug/min,n=39)and Massive proteinuria with nephropathy group(UAER>300 UG / min,n=45).The changes of Hcy,Hb Alc levels between the three groups were analyzed and compared.Pearson correlation analysis was used to research the relationship between serum Hcy,HbAlc levels and 24 h urine protein,At the same time,the relationship between serum Hcy,Hb Alc levels and e GFR was also discussed.In addition patients with type 2 diabetes mellitus had concurrent renal impairment as a status variable,and blood Hcy and HbAlc levels were used as test variables.The ROC curves were drawn by means of detection variables and state variables.Result: The levels of Hcy and Hb Alc in microalbuminuria with nephropathy group were higher than those in simple diabetic with no nephropathy group(p<0.05),and the levels of Hcy and Hb Alc in Massive proteinuria with nephropathy group were significantly higher than those in microalbuminuria with nephropathy group(p<0.05),24 h urine protein also increased,while eGFR decreased,the difference between groups was remarkablely significant(P<0.001);Pearson correlation analysis showed that the elevated levels of Hcy and Hb Alc in serum were positively correlated wit h 24 h urine protein(r=0.319 P<0.05,r=0.379 P<0.05),The increase of Hcy and Hb Alc in serum was significantly negatively correlated with e GFR(r=-0.508 P<0.05,r=-0.294 P<0.05);ROC curve analysis showed that Hcy and Hb Alc combined detection of early diabetic nephropathy under the curve area(AUC)were significantly greater than the two indicators Hcy and HbAlc single detection.Conclution: Diabetes mellitus and diabetic nephropathy,The levels of Hcy,Hb Alc increased gradually,but eGFR levels decreased gradually.The expression of Hcy and Hb Alc is related to the occurrence and development of diabetic nephropathy(DN).It is helpful for early detection of DN and monitoring the progress of patients with DN.The level of serum Hcy and Hb Alc in patients with type 2 diabetes mellitus has some guiding significance for the diagnosis,treatment and evaluation of renal function damage in patients with type 2 diabetes mellitus.