The Urine Trace Albumin/Creatinine Diagnosis Value Of Early Diabetic Nephropathy And The Analysis Of Its Risk Factors

Objective Confirmed the urine trace albumin/creatinine(urinary mALB/Cr)instead of the 24 h urine trace albumin(24h urinary m ALB)used for the accuracy of early diagnosis of DN,investigate early reach the targets of treatment and the effect on the urinary mALB/Cr,and discuss the influence factors of urinary mALB/Cr,to effectively prevent the occurrence and development of diabe-tic nephropathy.Method From December 2015 to June 2016,we collect the morning urine of T2 DM patients who were in the affiliated hospital of Qingdao university,and collect the fasting blood glucose,2h postprandial blood glucose,glycosylated hemog-lobin(HbA1C),fibrinogen(FIB),total cholesterol(CHOL),low density lipoprotein(LDL),highdensity lipoprotein(HDL),triglyceride(TG)and glomerular filtration rate(GFR),uric acid,retinopathy in installment,blood pressure,body mass index(BMI),waist hip ratio,diabetes duration,diabetes onset age,family history of diabetes,age,gender,weight,if they smoked or drinked and other data,due to there are too much independent variable,to avoid its influence each other,we first c-arries on the single factor analysis of the independent variables,statistical significance have statistical significance or close to have statistical was found to use theorderly multiclassification Logistic regression analysis,to explore the risk factors of urinary mALB/Cr.Collect the morning urine and 24 h urine of110 cases of them,urinary mALB/Cr and 24 h urinary mALB were separately measured,make a correlation analysis between the above two,the standard diagnosis of early diabeticnephropathy is 30mg/24 h urine,draw the receiver-operating characteristic curve(ROC curve),to evaluate the specificity and sensitivity which urinary mALB/Cr in the diagnosis of early diabetic nephropathy,The remaining 80 T2 DM patients whomeet eligibility criteria with 3 months follow-up,review of fasting blood glucose,glycosylated hemoglobin,urine mALB/Cr,creatinine and uric acid,according to the review of glycosylated hemoglobin value size we divided them into 5 groups,discuss the influence of urinary mALB/Cr,creatinine,uric acid about early diabeticnephropathy hypoglycemic therapy.Result(1)We can found a highly positive correla-tion(r=0.927,p<0.001)betweenthe urinary mALB/Cr and 24 h urinary mALB in T2 DM patients,with 30mg/24 h urine for the early diagnosis of DN gold standard,the corresponding urinary mALB/Cr area under the ROC curve is 0.932,with urin-ary mALB/Cr=29.75mg/g for diagnostic value,the diagnostic sensitivity and specif-icitywere 92.0% and 77.6%,which means that its have higher accuracy in dianog-nosisof diabetic nephropathy,and can replace of the 24 h urine m ALB for early screening diabetic nephropathy.(2)Nine arguments were chosed in orderly multi-classification Logistic regression analysis,the result shows that the risk factors of urina-ry mALB/Cr(p<0.05)inclueding the duration of diabetes,2h postprandial blood glucose,BMI,glycosylated hemoglobin,TG and fibrinogen.(3)Regulate blood sugar level ime to control the glycosylated hemoglobin under 7%,the follow-up found aprevious fall in urinary mALB/Cr,which the difference was statistically significant.Conclusion(1)Urinary albumin/creatinine have a highly correlation about 24 h urine trace albumin,which means it can instead of 24 h urine trace albumin use for early diabetic nephropathy screening and evaluations.(2)The long duration of diabetes,poor blood sugar control,triglycerides,obesity,high coagulation state is independent risk factors for the development of DN,they may interaction promote the development of DN.DN detection rate increases with the duration of diabetes,when duration of diabetes > 10 years,the effection is more significant on urinary mALB/Cr.(3)Control HbA1 C below 7% during early diabetic nephropathy,can significantly reduce urinary mALB/Cr and delay the development of diabetic nephropathy.