| Objective To explore the correlation between NRL,Cys-c,β2-MG,UA and abnormal UACR in patients with T2DM,then screen out an early sensitive indexes for predicting diabetic kidney disease(DKD).Methods In the Affiliated Nanhua Hospital,University of South China,Choose to be hospitalized in the Endocrinology Department from September 2019 to December 2020,which meet the inclusion and exclusion criteria.A total of 321 T2DM patients are selected as the research objects.According to the clinical classification criteria of urine albumin/creatinine ratio(UACR),all T2DM patients are divided into normal urine albumin group(UACR<30 mg/g,n=120)and microurinary albumin group(UACR:30～300mg/g,n=120)and large urine albumin group(UACR>300 mg/g,n=81).These groups will be compared with statistical method between each other,and using method of Spearman correlation analysis to analyze and compare the correlation between NRL,Cys-c,β2-MG,UA levels and the occurrence of abnormal UACR;Using the ROC curve to assess and compare the value of NLR,Cys-c,β2-MG,and UA in predicting the occurrence of abnormal proteinuria in T2DM patients;Using logistic regression analysis to explore the influencing factors of DKD in T2DM patients;Using SPSS20.0 software for statistical analysis,it is defined that P<0.05 was statistically significant.Results 1.Comparison of T2DM patients in different UACR groups for general clinical data and biochemical indicators shows that:The differences between the normal urine albumin group,the microurinary albumin group and the large urine albumin group of age,the course of diabetes,FCP,NLR,BUN,Scr,UA,e GFR,Cys-c,β2-MG,prevalence of hypertension,incidence of previous cardiovascular and cerebral infarction events are statistically significant(P<0.05);however,three groups of BMI,waist circumference,FBG,Hb A1c,TC,TG,HDL-C,LDL-C,gender,and smoking history were no significant differences(P>0.05).2.Spearman correlation analysis results shows that:relationship between NLR,Cys-c,β2-MG,UA and abnormal UACR in T2DM patients is a positive correlation(Respectively r_svalues are 0.342,0.534,0.520,0.288,P<0.05),and Cys-c and abnormal UACR have the largest r_s,maybe Cys-c has a stronger correlation with abnormal UACR.3.ROC curve analysis shows that:the occurrence of abnormal proteinuria in patients with T2DM can be predicted NLR,Cys-c,β2-MG,UA,and their areas under the ROC curve respectively are 0.698,0.766,0.735,0.634(95%CI respectively were0.640～0.756,0.715～0.816,0.680～0.791,0.573～0.695,all P values<0.05),and when the NLR value is 2.675,the Cys-c value is 1.095,theβ2-MG value is 2.305,and the UA value is 311.5,their Youden index=0.305,0.450,0.355,0.260,at this time,the corresponding sensitivity respectively is 67.2%,64.2%,67.2%,65.2%,and the specificity respectively is 63.3%,80.8%,68.3%,60.8%;In addition,compared with NLR,β2-MG and UA,area of Cys-c under the ROC curve for predicting abnormal proteinuria in T2DM patients is largest,this shows that predictive value of Cys-c is greatest and to predict the occurrence and development of DKD may better.4.Multivariate logistic regression analysis results shows that:Course of Diabetes(OR=1.061,95%CI:1.003～1.122),NLR(OR=1.504,95%CI:1.213～1.864),Cys-c(OR=21.296,95%CI:2.217～204.589),hyperten-sion(OR=0.465,95%CI:0.252～0.857)is independent risk factors for occurrence of DKD(all P values<0.05).Conclusions 1.NLR,Cys-c,β2-MG and UA are all related to the occurrence of abnormal UACR,which can predict the early renal injury in T2DM patients,and Cys-c has higher predictive value.2.The course of diabetes and hypertension are independent risk factors of DKD. |
