| Research objectives:By analyzing the relationship between different levels of serum uric acid(SUA)and diabetes nephropathy(DN)in patients with type 2 diabetes(T2DM),we can improve clinicians’ understanding of the risk factors of diabetes nephropathy and provide theoretical basis for early diagnosis and prevention of the disease.Research methods:This study is a retrospective cross-sectional study that collected 200 patients with T2 DM who were definitely diagnosed in China-japan Friendship Hospital from January 1,2022 to December 31,2022.Data of the subjects were collected: age,gender,course of diabetes,smoking history,drinking history,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),glycosylated hemoglobin(Hb A1c),fasting plasma glucose(FPG),fasting C-peptide(FCP),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN)Creatinine(Cr),25 hydroxyvitamin D(25(OH)D),insulin resistance index(HOMR-IR),urinary albumin/creatinine ratio(UACR),diabetes peripheral vascular disease(PVD),diabetes retinopathy(DR),and diabetes peripheral neuropathy(DPN).The American diabetes Association(ADA)recommends screening and diagnosis of microalbuminuria by measuring the urinary albumin/creatinine(UACR)of instant urine samples.According to the results of UACR detection,they can be divided into:Simplicity diabetes mellitus(SDM)(UACR<30mg/g),early diabetes nephropathy(EDN)(30mg/g ≤ UACR<300mg/g),Clinical diabetes nephropathy(CDN)group(UACR ≥ 300mg/g),analyze the correlation between the blood uric acid and other clinical data among each group and the UACR index of diabetes nephropathy.At the same time,the blood uric acid level is divided into four quartiles: Q1,Q2,Q3,Q4.The number of patients in each group is 50.The grouping is as follows: the first quartile(Q1): 0-303.66 μmol/l,2nd quartile(Q2): 303.66-370.00μmol/l,3rd quartile(Q3): 370.00-474.91μmol/l,4th quartile(Q4):>474.91μmol/l,To further analyze the correlation between DN and serum uric acid.SPSS 25.0 was used for statistical analysis and processing of the above data,with P<0.05 indicating a statistical difference.Results:1.The results of comparing the general clinical data of the three groups showed that: There were statistically significant differences in the duration of disease,SBP,history of hypertension,combined diabetic peripheral vascular disease(PVD),and combined diabetic peripheral neuropathy(DPN)among the three study groups(P <0.05).The differences in the duration of disease and history of hypertension in the CDN group compared with the SDM and EDN groups were statistically significant(P< 0.05).The differences in SBP and combined PVD in the CDN group compared with the SDM group were statistically significant(P < 0.05).the differences in combined PVD in the EDN group compared with the SDM group were statistically significant(P < 0.05).2.The comparison of laboratory examination indicators among the three groups of patients showed that there were statistically significant differences in FPG,Cr,e GFR,BUN,SUA,HDL-C,and 25(OH)D among the three groups of study subjects(P<0.05).Compared with SDM group and EDN group,Cr and SUA in CDN group were significantly increased(P<0.05),while e GFR and 25(OH)D were significantly decreased(P<0.05).Compared with SDM group,BUN in CDN group was significantly higher(P<0.05).Compared with EDN group,FPG in CDN group was significantly lower(P<0.05).Compared with SDM group,SUA in EDN group was significantly increased(P<0.05),while 25(OH)D was significantly decreased(P<0.05).3.The results of single factor analysis of the risk of DN showed that there was a positive correlation between the course of disease,history of hypertension,PVD,DPN,Cr,BUN,SUA,and the risk of DN in Q3 and Q4 groups(P<0.05);EGFR,25(OH)D were negatively correlated with the risk of DN(P<0.05).4.The results of multivariate logistic regression analysis on the risk of DN showed that blood uric acid was a risk factor for DN,and the risk of DN increased with the increase of blood uric acid level.The risk of DN in the Q3 group was 2.634 times higher than that in the Q1 group(OR=2.634,95% CI: 1.019 to 6.805),and the risk of DN in the Q4 group was 30.960 times higher than that in the Q1 group(OR=30.960,95% CI: 5.926 to 161.743).25(OH)D is a protective factor for DN.As the level of 25(OH)D increases,the risk of DN decreases(OR=0.901,95% CI:0.850-0.956,P<0.001).5.Spearman correlation analysis showed that serum uric acid level was positively correlated with BMI,SBP,FBG,FCP,Cr,e GFR,BUN,UACR,TG,TC,LDL-C,urine PH,and 25(OH)D(P<0.05),while it was negatively correlated with BMI,SBP,FCP,Cr,BUN,UACR,TG,TC,and LDL-C(P<0.05).There is a strong correlation between serum uric acid and indicators of renal function impairment,which are UACR(r=0.588),BUN(r=0.261),Cr(r=0.516),and e GFR(r=-0.342),respectively.Conclusion:1.In T2 DM patients,the level of serum uric acid is positively correlated with the occurrence of DN.With the increase of serum uric acid,the prevalence of DN increases.2.In clinical diagnosis and treatment,attention should be paid to the monitoring of blood uric acid in T2 DM patients,and when the patient’s uric acid rises,attention should be paid to the screening of diabetes nephropathy as early as possible. |
PDF Full Text Request