| Objective:The purpose of this study was to investigate the relationship between homocysteine(Hcy)levels and carotid atherosclerosis in patients with type 2 diabetic kidney disease,and to further study the effect of clinical indicators of diabetic nephropathy on Hcy levels.Methods:A total of 159 patients with type 2 diabetic kidney disease who were admitted to the China-Japan Union Hospital Of Jilin University from March 2019 to November 2019 were selected.Carotid artery color Doppler ultrasound examination was used to detect the carotid intima-media thickness(CIMT)and the presence or absence of carotid plaque formation.According to the carotid endometrial examination results,they were divided into two groups.In the normal carotid artery group,CIMT <1.0 mm,a total of 50 cases;in the carotid atherosclerosis group,CIMT ? 1.0 mm,with or without plaque formation in the neck artery,a total of 109 cases.Collect and compare the general clinical data,biochemical indexes and carotid color Doppler ultrasound indexes of the two groups of patients.Logistic regression analysis was used to compare the effects of independent variables on CIMT thickening and plaque formation.According to the level of Hcy,patients was divided into three groups.Hcy <10 umol / L was group A,10?Hcy <15umol / L was group B,Hcy?15umol / L was group C,adjusted the inspection level to 0.0167,and compare each group The incidence of carotid atherosclerosis.The receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of Hcy for carotid atherosclerosis in patients with type 2 diabetic kidney disease.Spearman's bivariate correlation analysis was used to explore the correlation between Hcy levels and various indicators in all patients.Results:1.Among the patients with type 2 diabetic kidney disease,the Hcy,urea,and age of the carotid atherosclerosis group were higher than that of the normal group,the difference was statistically significant(P <0.05);2.Whether there was CIMT thickening and plaque formed as a dependent variable for binary logistic regression analysis,adjusting for confounding factors,it was found that Hcy was still an independent risk factor for CIMT thickening and plaque formation(P <0.05).3.Differences in CIMT thickening and plaque formation rate among the three groups of patients with different Hcy levels were statistically significant(P <0.05).Further comparison show that the CIMT thickening and plaque formation rate in group C patients was higher than that in group A and Group B;the difference was statistically significant(P <0.0167).there was no statistically significant difference in CIMT thickening and plaque formation rate between group B and group A(P> 0.0167).4.Analyze the value of Hcy for the diagnosis of carotid atherosclerosis through the receiver operating characteristic curve(ROC curve): the area under the ROC curve is 0.731,P <0.001,when the Hcy cutoff value is 11.865 mmol / L,the predicted sensitivity is 60.6% and the specificity is 88.0%.5.Spearman's bivariate correlation analysis showed that Hcy levels in patients with type 2 diabetic nephropathy were positively correlated with age,serum creatinine,urea,cystatin C,and serum uric acid(r = 0.173,0.450,0.289,0.449,0.276,P <0.05 or P <0.01),which was negatively correlated with the estimated glomerular filtration rate(eGFR)(r =-0.331,P <0.01).Conclusions:1.In patients with type 2 diabetic nephropathy,patients with concurrent carotid atherosclerosis have significantly increased Hcy levels,and as Hcy levels increase,the incidence of carotid atherosclerosis increases;2.Elevated Hcy is an independent risk factor for carotid atherosclerosis in patients with type 2 diabetic nephropathy,and has certain predictive value for the occurrence of carotid atherosclerosis;3.In patients with type 2 diabetic nephropathy,Hcy levels are positively correlated with age,serum creatinine,urea,cystatin C,and serum uric acid levels,but negatively correlated with eGFR,and no obvious correlation with ACR. |
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