Changes Of Serum Chitinase-3 Like Protein-1 And Homocysteine Levels In Type 2 Diabetic Nephropathy

Objectives By measuring serum chitinase-3 like protein-1(YKL-40)and homocysteine(HCY)level,we explored the relationship between serum YKL-40 and HCY and type 2 diabetic nephropathy.Methods According to the level of urinary albumin excretion(UAER),121 cases of type 2 diabetes in North China University of Science and Technology Affiliated Hospital were selected and divided into two groups: 78 patients with type 2 diabetic nephropathy(DN group)and 43 patients with type 2 diabetes non-nephropathy(DM group)served as control group.The DN group included 40 patients with early diabetic nephropathy(DN1)and 38 patients with advanced diabetic nephropathy(DN2).Each patient's height,weight,BMI,DBP,SBP,fasting insulin(Fins),fasting plasma glucose(FPG),fasting C-peptide(FC),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C),triglyceride(TG),total cholesterol(TC)),glycated hemoglobin(Hb A1c),BUN,Cr,UA,HCY,YKL-40 were measured,and each patient's insulin resistance index(HOMA-IR)was calculated.All data were statistically analyzed by using SPSS 17.0.Measured data were expressed as mean ± standard deviation(x ±s).The t-test method was used to compare the two groups.Count data were analyzed using ?2 test;Pearson correlation analysis was used among the indexes;Logistic regression analysis was performed using unconditional two-class classification.Screening for risk factors.Results 1 ?2 test was used on gender composition,the results suggested that DM group and DN group have no significant difference.2 There was no significant difference in the age,DBP,Fins,FC,C-peptide,HOMA-IR,HDL-C,LDL-C,and UA levels between DM group and DN group according to the result of t-test.3 The duration of disease,BMI,SBP,FPG,Hb A1 c,TC,TG,BUN,and Cr in DN group were higher than those in DM group.4 The serum HCY level in DN group was higher than that in DM group and increased with the severity of DN.When HCY> 15 umol / l,the risk of T2 DM patients combined with DN was increased by 8.01 times.By taking HCY as the dependent variable,and using Pearson correlation analysis.The results suggest that HCY was positively correlated with the duration of disease,YKL-40,FPG,Hb A1 c,Cr,UAER,TG and BUN.5 The level of serum YKL-40 in DN group was higher than that in DM group and increased with the severity of DN.When> 108 ng / ml,the risk of T2 DM patients combined with DN was increased 9.93 times.Taking YKL-40 as the dependent variable,the result of Pearson correlation analysis showed that YKL-40 and HCY,UAER,FPG,duration,Cr,BUN,Hb A1 c,TG,BMI,SBP,TC was positively correlated.6 Taking the duration of course,BMI,SBP,FPG,Hb A1 c,TC,TG,BUN,Cr,HCY,and YKL-40 which were statistically significant indicators as independent variables,and whether diabetes nephropathy as the dependent variable,the logistic regression of unconditional two-class classification was performed showed that the HCY,YKL-40 levels of serum and T2 DM combined DN was positively correlated.Besides,duration,SBP and Cr levels were also positively correlated with T2 DM combined DN.Conclusions 1 Serum levels of YKL-40 and HCY in patients with type 2 DN were higher than those with type 2 DM alone,and their levels increased with the severity of DN.2 Serum levels of YKL-40 and HCY are associated with the development and progression of type 2 DN,and when their levels are elevated,the risk of type 2 DN is increased.