Serum Level Of Bile Acid In Patients With Type 2 Diabetes Mellitus And Diabetic Kidney Disease And Their Correlation Factors

ObjectiveThe purpose of this study is to investigate serum level of total bile acid in patients with type 2 diabetes mellitus and diabetic kidney disease and their correlation factors.Methods445 patients with T2DM as DM group and 449 Non-type 2 diabetic patients who underwent physical examination at the same time were treated as healthy control group(NDM group)in our hospital from January 2017 to October 2018 were recruited in this study.According to the diagnostic criteria of diabetic kidney disease the patients with T2DM were devided into non-diabetic kidney disease group(NDKD group,n= 280)and diabetic kidney disease group(DKD group,n= 165).The age,sex,height,weight and other general information as well as biochemical indexes such as TBA,fasting plasma glucose(FPG),fasting insulin(FINS),hemoglobin A1c(HbA1c),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-c),high density lipoprotein cholesterol(HDL-c)and so on in the two groups were collected,waist circumference(WC)and diabetes duration(DD),Fasting c-peptide(FC-P)in the DM group were collected.The correlation factors affecting TBA and the changes of serum TBA in T2DM and DKD.ResultsIn the general population,serum TBA level was correlated with age,fasting plasma glucose(FPG),fasting insulin(FINS),hemoglobin A1C(HbA1C),and triglyceride(TG)levels(P<0.05).After adjusting for other influencing factors,serum TBA level in the type 2 diabetes group was significantly higher than that in the healthy control group,3.90(95%CI:3.68-4.13)VS 2.91(95%CI:2.68-3.13)umol/l,P<0.05;the serum TBA level of type 2 diabetic patients with diabetic kidney disease is lower than that of non-diabetic kidney disease patients,3.10(95%CI:2.71-3.49)VS 4.39(95%CI:4.09-4.69)umol/l,P<0.05.In patients with type 2 diabetes,multivariate logistic regression analysis of DKD was conducted by taking DKD as the dependent variable,the results showed that diabetes duration(DD)and Serum creatinine(Scr)were risk factors for DKD in T2DM patients,while TBA was a protective factor for DKD((OR=0.802,95%CI:0.724-0.809,P<0.05).ConclusionSerum TBA level may be related to the disorder of glucose and lipid metabolism.Serum TBA level increased in type 2 diabetic patients,but decreased in type 2 diabetic patients with diabetic kidney disease.Bile acid may be a protective factor for diabetic kidney disease.