Analysis Of Risk Factors Of Urinary Microalbumin In Patients With Newly Diagnosed Type 2 Diabetes Mellitus

BackgroundDiabetic nephropathy refers to the complications of diabetes caused by abnormal renal function and structure,once it enters the end stage,it will bring systemic metabolic disorder or even bad outcome.Diabetic nephropathy is a harmful and occult complication.Urinary microalbumin is an important index for early diagnosis of diabetic nephropathy.In recent years,it has been found that urinary microalbumin can occur in the early stage of type 2 diabetes,so early detection of urinary microalbumin is of great significance to prevent the occurrence and development of diabetic nephropathy.Objectiveexplore the associated risk factors of urinary microalbumin/uric creatinine(albumin to creatinine ratio,ACR)in patients with first-visit type 2 diabetes.Method1.Subjects:From January 2018 to November 2019,112 patients with type 2 diabetes were first diagnosed in the Department of Endocrinology of Hebi People’s Hospital.The patients were selected to exclude acute complications of diabetes,cardiac insufficiency,malignant hypertension,primary nephropathy,connective tissue immune system diseases,kidney disease caused by infection and tumor,severe infection or other systemic diseases and serious primary diseases.2.Recording indicators:All patients were recorded for age,sex,height,weight,blood pressure,body mass index(BMI),Body Weight/Height ~2(Kg/m~2),and whether they smoked,improve Fasting Blood Glucose(FBG),Glycated hemoglobin,total cholesterol(Chol),triglyceride,high-density Lipoprotein,Low-density Lipoprotein,blood uric acid(UA),homocysteine,fibrinogen(FIB),the ratio of urinary microalbuminuria to Urinary Creatinine(ACR)was calculated in mid-morning urine under the condition of life and Diet.3.Case group:the diabetic patients were divided into two groups according to the urine microalbumin/urine creatinine ratio(ACR):ACR negative group:urine microalbumin negative(ACR<30mg/g),ACR positive group:urine microalbumin positive(ACR≥30mg/g).between the study ACR and various related factors.Results1.A total of 112 patients were collected,of which 81 were male and 31 were female,aged 17~70 years,with an average of 43.86 years old.Among the first diagnosis of type 2diabetes,72.32%were male,and the incidence of male was high.ACR positive rate was41.96%in all patients.2.The HbAlc of ACR positive group was higher than that of negative group,and the difference between the two groups was statistically significant(P<0.05).the increase in HbAlc levels was positively correlated with ACR abnormalities(r=0.597 P<0.001).3.The HCY of ACR positive group was higher than that of negative group,and the difference between the two groups was statistically significant(P<0.05).the increase in HCY levels was positively correlated with ACR abnormalities(r=0.681 P<0.001).4.Multivariate logistic regression analysis:the increase in HbAlc、HCY levels was a risk factor for ACR abnormalities,P<0.05.5.ROC curve analysis:HbAlc、HCY combined test was HbAlc、HCY to evaluate the area under the curve of early nephropathy in type 2 diabetes mellitus.The predicted cut point HbA1c was 10.5%and HCY was 15.62 umol/L.ConclusionThe positive rate of ACR in patients with type 2 diabetes was high,and the increase of HbAlc、HCY level was a risk factor for ACR abnormalities in patients with type 2 diabetes,and was positively correlated with ACR abnormalities.combined detection HbAlc、HCY has certain guiding significance for the evaluation of early renal damage in patients with type 2 diabetes.