| ObjectiveThrough studying the expression of the fraction excretion of uric acid(FEUA%)in different stages of type 2 diabetic nephropathy(DN),analysis the significance of fraction excretion of uric acid and its correlation with the occurrence and development of the type 2diabetic nephropathy(DN),and study the influencing factors of FEUA%,for exploring whether it can be used as an early indicator of diabetic nephropathy and the starting point of intervention treatment,and to provide new ideas for the prevention and treatment of delaying the development of diabetic nephropathy.MethodsChoicing the WHO diagnostic criteria of type 2 diabetes mellitus which made in 1999 and the type 2 diabetic nephropathy as the diagnostic standard,selecte 72 cases of simple diabetes mellitus(T2DM group),69 cases of early type 2 diabetic nephropathy(EDN group),and 70 cases of clinical type 2 diabetic nephropathy(CDN group)as the research object,which were all treated in the Qingdao municipal hospital,s department of endocrinology of the eastern and western hospital from January 2017 to December 2018.In addition.At the same time,71 healthy patients who were examined at the same hospital were selected as the normal control group(NGT group)during the same time.We would ask all subjects mang questions such as their past medical history and short-term medication status in detail,and collect their general clinical data including their age,sex,body mass index(BMI),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),serum creatinine(Cr),Blood urea nitrogen bun(BUN),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholestero(HDL-C),low density lipoprotein cholestero(LDL-C),blood uric acid(SUA),the test of the urinary albumin / creatinine ratio(ACR),urinary uric acid(UUA)and urine creatinine(UCr)to calculate the patient's insulin resistance index(HOMA-IR(Cp)determine the fraction excretion of uric acid(FEUA%)by collecting 24hours' urine.Results(1)The levels of FEUA% in T2 DM group,EDN group and CDN group(11.02±3.52?9.72±2.03?8.45±2.54)% were all respectively lower than those in NGT group(13.91±5.99)%(P<0.05).At the same time,the CDN group was significantly lower than T2 DM group and EDN group(P < 0.05).(2)The levels of FEUA% in each group was positively correlated with FPG and HbA1 c,and the correlation coefficient r were 0.117 and 0.126,respectively(P < 0.05),while the levels of FEUA% was negatively correlated with HOMA-IRA(Cp),SCr,TG,SUA,ACR,and BMI,which correlation coefficient r were-0.073,-0.169,-0.067,-0.205,-0.335,and-0.287(P < 0.05).(3)Logistic regression analysis showed that FEUA%,FPG,SCr and HDL were independent influencing factors of diabetic nephropathy,and the standard coefficients were-0.249?-0.236?0.210?0.111,respectively(P< 0.05).Conclusion(1)The patients' levels of FEUA% with simple type 2 diabetes,early type 2 diabetic nephropathy,and clinical type 2 diabetic nephropathy were all lower than those in the normal control group,and FEUA% in the three groups showed a decreasing trend.Binding FEUA% was positively correlated with fasting glucose level and glycosylated hemoglobin,and correlated with insulin resistance index negatively,suggesting that FEUA% was associated with the occurrence of type 2 diabetes and type 2 diabetic nephropathy.Combined with the regression analysis showed that FEUA were independent factors affecting the urine albumin to creatinine ratio,it shows that in the process of type 2 diabetic nephropathy progress FEUA % played an important role,is closely related to the loss of renal function,therefore FEUA % can be used as indicators of early detection of type 2 diabetic nephropathy,diabetic nephropathy for prevention and early intervention to provide new ideas.(2)FEUA% was negatively correlated with triglycerides and body mass index,suggesting that improving blood lipid status and weight loss can improve uric acid excretion fraction,thereby delaying the occurrence and development of diabetic nephropathy and possibly contributing to the control of diabetic nephropathy. |
PDF Full Text Request