Application Value Of Combined Detection Of Cystatin C,Retinol Binding Protein And Serum Uric Acid In Early Diagnosis Of Diabetic Kidney Disease

Objective:Diabetic kidney disease is one of the most advanced complications of diabetes.To explore the predictive value and diagnostic efficacy of the combined model of serum uric acid(UA),retinol binding protein(RBP)and cystatin C(Cys C)in the diagnosis of diabetic kidney disease.Methods:329 patients with type 2 diabetes mellitus who were hospitalized in the First Hospital of Jilin University from July 2017 to July 2020 were selected.To collect the basic data and biochemical indexes of patients,and then divide the patients into 3groups according to the amount of urinary microalbumin excretion.By analyzing the differences of each index in this 3 groups and their correlation with urinary microalbumin,to evaluate the predictive value and clinical diagnostic efficacy of UA、RBP and Cys C in early diabetic kidney disease.Results:There were statistically significant differences in UA、RBP and Cys C among the three groups.The UA、RBP and Cys C in the early diabetic kidney disease group were higher than those in the simple diabetic kidney disease group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that UA(r=0.362,P<0.001),RBP(r=0.378,P<0.001)and Cys C(r=0.617,P<0.001)is positively correlated with urinary microalbumin.Logistic regression analysis showed that UA、RBP and Cys C were independent risk factors for urinary microalbumin.The UA、RBP and Cys C were included in the model to establish the early diabetic kidney disease risk prediction model and draw a nomogram.The differentiation of The model was verified by ROC curve analysis,and the results showed that the nomogram model is the best model compared to the above three single indicators and the combination of the two indicators,and has better predictive performance in early diabetic kidney disease(AUC=0.838,95%CI:0.792,0.876).Moreover,when Cys C >0.9mg/L,RBP>50mg/L,and UA>330umol/L,the patient has a high risk of early diabetic kidney disease,and the probability of developing the disease is 77%.Conclusions:The combination of UA、RBP and Cys C can accurately predict the early diabetic kidney disease,which is of clinical value in the early diagnosis of diabetic kidney disease.