| ObjectCardiac metabolic index(CMI)is a new index proposed in recent years.Previous studies have shown that CMI is closely related to diabetes,atherosclerosis,ischemic stroke,hypertension and other diseases.However,the relationship between CMI and albuminuria in patients with type 2 diabetes mellitus(T2DM)remains unclear.The purpose of this study is to provide a reference for the early diagnosis of diabetic kidney disease(DKD)by analyzing the correlation between CMI and albuminuria in patients with T2DM.MethodA total of 555 patients with T2DM in our hospital from February 2012 to July2020 were selected.The basic parameters of the patients were measured andthe clinical indicators such as urinary albumin / creatinine ratio(UACR)were detected.According to the UACR value,the patients were divided into normal albuminuria group(UACR<30mg/g,n=294),microalbuminuria group(30mg/g≤UACR<300mg/g,n=209)and macro albuminuria group(UACR≥300mg/g,n=52),the differences of clinical indicators and CMI levels between the three groups were compared.Besides,according to the triad of CMI level,the patients were divided into L-CMI group(CMI<0.63,n=185),M-CMI group(0.63≤CMI<1.12,n=185)and H-CMI group(CMI≥1.12,n=185),and the differences of clinical indicators and the incidence of abnormal albuminuria among 3 groups was compared.The correlation between CMI and UACR was analyzed,and the relationship between CMI and the risk of albuminuria occurrence was discussed.What’s more,the predictive value of CMI for albuminuria in T2 DM patients was evaluated by receiver operating characteristic(ROC)curve.Results(1)Compared with normal albuminuria group,the value of cardiac metabolic index(CMI),systolic pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),triglyceride(TG),total cholesterol(TC),hemoglobin A1c(Hb A1c),fasting plasma glucose(FPG),fasting C peptide(FC-P),homeostasis model of insulin resistance index(HOMA-IR)and serum uric acid(SUA)in microalbuminuria group and macroalbuminuria group were significantly increased(P<0.05 or P<0.01);high density lipoprotein cholesterol(HDL-C)was gradually decreased(P<0.01).Compared with microalbuminuria group,CMI,SBP,TG,SUA and SCR in macroalbuminuria group were significantly increased(P<0.05 or P<0.01),and estimated glomerular filtration rate(e GFR)was significantly decreased(P<0.01).(2)Compared with L-CMI group,UACR,BMI,SUA,TC,LDL-C,FIns,FC-P and HOMA-IR in the M-CMI group and H-CMI group were significantly increased(P<0.05 or P<0.01).Compared with M-CMI group,UACR,BMI,BUN,SUA and HOMA-IR were significantly increased in H-CMI group(P<0.05 or P<0.01).With the increased level of the triad of CMI,the incidence of abnormal albuminuria was gradually increased(P<0.01).(3)Correlation analysis showed that UACR was positively correlated with CMI,SBP,DBP,BMI,TG,TC,Hb A1 c,FPG,FIns,FC-P,HOMA-IR,BUN,SUA and SCr,negatively correlated with HDL-C and e GFR(P<0.05 or P <0.01).Besides,CMI was positively correlated with UACR,BMI,BUN,SUA,FPG,FIns,FC-P,Hb A1 c,TC and HOMA-IR(P<0.05 or P <0.01).(4)Multiple linear regression analysis showed that CMI was independently associated with UACR[B=0.180,95%CI:0.133～0.226,P<0.01].(5)Logistic regression analysis showed that CMI was an independent risk factor for the occurrence of abnormal albuminuria in T2 DM patients [ OR=16.001,95%CI:8.951～28.604,P<0.01].(6)The ROC analysis showed that the area under the curve(AUC)predicted by CMI for the occurrence of abnormal albuminuria is 0.801(95%CI: 0.765～0.837,P<0.01).Taking the optimal critical value of 0.455,the sensitivity and specificity of predicting abnormal albuminuria were 68.6% and 76.9%.ConclusionsCMI gradually increased with the increase of urinary albumin level in T2 DM patients.CMI was an independent risk factor for the occurrence of abnormal albuminuria in T2 DM patients.CMI had a good predictive value for the occurrence of abnormal albuminuria in T2 DM patients.CMI was expected to become a predictor for the occurrence and development of DKD. |
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