| Objective:To investigate the change of General data and biochemicalindicators levels in patients with Type 2 Diabetes Mellitus（T2DM）and early Diabetic Nephropathy（DN）,and Looking for factors that may affect the occurrence and development of DN,and to further explore the application value of this influencing factor in the early diagnosis of DN.Methods:We selected the patients 202 cases from July 2016 to December 2018 in our hospital.We also choosed 64 cases as control group from our hospital medical center at the same time.（2）According to different degrees of UACR and GFR:Non-diabetic nephropathy group（UACR<30ug/mg,GFR≧90ml/min/1.73m~2）,Early diabetic nephropathy group（UACR30-300ug/mg,GFR≧90ml/min/1.73m~2）,Clinical diabetic nephropathy group（UACR>300ug/mg,GFR<90ml/min/1.73m~2）.（3）Subjects’age,gende,course of disease,family history of diabetes,body mass index（BMI）and other general information were collected.Next morning after fasting 8h venous blood was collected,the determination of blood glucose（FPG）,glycosylated hemoglobin（Hb A1c）,triglycerides（TG）,cholesterol（CHOL）,high-density lipoprotein cholesterol（HDL-c）,low density lipoprotein cholesterol（LDL-c）,serum creatinine（SCr）,blood urea nitrogen（BUN）,uric acid（UA）,alpha 1 microglobulin（alpha1-MG）,retinol binding protein（RBP）and transferrin（TRSF）,n-acetyl-beta-glucosamine glycosidase（NAG）,the levels of Cystatin C（Cys C）.Urine samples were collected three times on different days and sent for examination to determine the urinary microalbumin（Um ALB）/creatinine（UCr）ratio.The differences in general data and biochemical indexes between the four groups were compared,using logistic single factor and multi-factor regression analysis,the risk factors of the development of dn and development were analyzed.By mapping the roc curve of the dn related factors and calculating the product of the curve,the prediction value of the serum biochemical index of the significant serum biochemical index was evaluated.Results:There was no significant difference between the control group and T2DM groups in gender composition ratio,DBP,smoking history and drinking history（P>0.05）.The course of disease increased successively in Non-diabetic nephropathy group,early DN group and clinical DN group,and the difference was statistically significant（P<0.05）.Compared with the control group and Non-diabetic nephropathy group,the differences in age and history of hypertension in the early DN group were statistically significant（P<0.05）.FPG,2h PG,and Hb A1c were significantly lower in the normal control group than in the Non-diabetic nephropathy group,the early DN group,and the clinical DN group,with statistically significant differences（P<0.05）.TG,CHOL,and LDL-c were significantly lower in the normal control group than in the DM group,the early DN group,and the clinical DN group,with statistically significant differences（P<0.05）.HDL-c was significantly higher in the normal control group than in the Non-diabetic nephropathy group,the early DN group,and the clinical DN group,and the difference was statistically significant（P<0.05）.Compared with the control group and Non-diabetic nephropathy group,BUN and SCr were significantly increased and GFR significantly decreased in the early DN group,with statistically significant differences（P<0.05）.α1-MG increased successively in the control group,Non-diabetic nephropathy group,early DN group and clinical DN group,and the difference between the early DN group and Non-diabetic nephropathy group was statistically significant（P<0.05）.TRSF decreased successively in the control group,Non-diabetic nephropathy group,early DN group and clinical DN group,and the differences between the early DN group and the control group and Non-diabetic nephropathy group were statistically significant（P<0.05）.RBP increased successively in the control group,Non-diabetic nephropathy group,early DN group and clinical DN group,and the difference was statistically significant between the early DN group and the control group and Non-diabetic nephropathy group（P<0.05）.NAG increased successively in the control group,Non-diabetic nephropathy group and early DN group,and decreased slightly at the beginning of clinical DN stage,and the difference between the early DN group and the control group and Non-diabetic nephropathy group was statistically significant（P<0.05）.Cys C increased successively in the control group,Non-diabetic nephropathy group,early DN group,and clinical DN group,and the difference between the early DN group and the control group and Non-diabetic nephropathy group was statistically significant（P<0.05）.Binary Logistic regression analysis results show thatα1-MG,TRSF,RBP,NAG,Cys C are independent factors affecting the incidence of diabetic nephropathy.Among themα1-MG,RBP,NAG,Cys C were risk factors and TRSF were protective factors.ROC curves were drawn and calculated,indicating thatα1-MG,NAG,Cys C have predictive value in the diagnosis of early diabetic nephropathy.Conclusions:（1）α1-MG,NAG,Cys C,RBP and TRSF were the risk factors of early diabetic nephropathy,and TRSF was the protective factor.（2）α1-MG,NAG,Cys C have predictive value in the diagnosis of early diabetic nephropathy,providing help for the early detection of diabetic kidney injury. |
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