Study On The Correlation Between NLR?MPV And Renal Artery Blood Flow Velocity And Resistance Index In Early Stage Diabetic Nephropathy

Objective:To explore the revelence between NLR,MPV and blood flow velocity and resistance index of renal arteries at all levels in early stage DN,to provide clinical reference value for the diagnosis of early diabetic nephropathy.Methods:According to the principle of random sampling,300 patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,Affiliated Hospital of Qinghai University from November 2018 to November 2019 and met the diabetes classification and diagnostic criteria issued by the World Health Organization(WHO)in 1999 were selected,and according to the 24-hour urinary albumin excretion rate(UAER),40 patients with UAER<30mg/24 h were randomly selected as the T2 DM alone group and 40 patients with UAER between 30 and 300mg/24 h were selected as the early DN group.Meanwhile,Randomly selected 40 cases from physical examination population as control group.The general data,blood routine examination(including NLR,MPV),biochemical indicators and UAER of the study subjects were collected.Doppler ultrasonography of both renal arteries was performed in the three groups to observe the renal blood perfusion and record the blood flow velocity(PSV,EDV)and resistance index(RI)of the renal arteries at all levels.The statistical software was SPSS21.0.Results:(1)Comparison of general information among the three groups: the age level in the early DN group was higher than which in diabetes alone group and control group,and they had significant differences(P<0.05);The course of disease in the early DN group was significantly longer than that in the T2 DM alone group(P<0.05).(2)Comparison of blood routine among the three groups: the NLR and NC level of the early DN group were higher than which of the diabetes alone group(P<0.05);the NLR,WBC,NC,and MC of the early DN group were higher than which of the control group(P < 0.05),and the LC level was lower than the control group(P<0.05);the MC of the diabetes alone group was higher than the control group(P<0.05),and the LC was lower than the control group(P<0.05).The MPV level among the three groups had no significant difference(P>0.05)(3)Comparison of biochemical data among the three groups: the levels of SCr,BUN,FPG and Hb A1 C in early DN group were higher than those in diabetes alone group(P<0.05);the levels of TG,SCr,BUN,FPG and Hb A1 C in early DN group were higher than those in control group(P<0.05);the levels of TG,FPG and Hb A1 C in diabetes alone group were higher than those in control group(P<0.05);the HDL level in early DN group and diabetes alone group were lower than those in control group(P<0.05).(4)Binary logistic regression analysis results of early DN risk factors:early DN was independently associated with NLR,age,diabetes duration,and Hb A1C(P<0.05).(5)Comparison of blood flow parameters of renal arteries at all levels among the three groups:PSV and EDV of renal arteries at all levels in the early DN group were statistically lower than those in diabetes alone group and control group(P<0.05),RI of renal arteries at all levels were statistically higher than those in diabetes alone group and control group(P<0.05).(6)NLR in patients with early diabetic nephropathy was negatively correlated with PSV and EDV of renal arteries at all levels and positively correlated with RI of renal arteries at all levels;NLR in patients with simple T2 DM was negatively correlated with PSV values of MRA and SRA,but not correlated with PSV of IRA,EDV and RI of renal arteries at all levels(P>0.05);NLR in healthy controls was not correlated with PSV,EDV and RI of renal arteries at all levels(P>0.05).Conclusion:(1)NLR levels increase significantly with the development of early diabetic nephropathy.(2)NLR and age,diabetes duration,and Hb A1 C were risk factors for early DN.(3)NLR was negatively correlated with renal artery blood flow velocity at all levels and positively correlated with resistance index in patients with early diabetic nephropathy.(4)MPV is less likely to be associated with renal artery blood flow velocity and resistance index in patients with early DN.