| Objective:By measuring the ratio of blood TG/HDL-C and HCY to urinary microalbumin and urinary creatinine（UACR）in patients with type 2diabetes,this study explored whether TG/HDL-C and HCY were correlated with diabetic nephropathy and the diagnostic value of predicting DKD in patients with type 2 diabetes.Methods:This study is a retrospective cross-sectional study.170 patients with type 2 diabetes who were admitted to the Department of Endocrinology and Metabolism of China-japan Friendship Hospital of Jilin University from December 2019 to December 2021 were selected as subjects.Basic data of subjects were collected: gender,age,diabetes course,height,weight,systolic blood pressure and diastolic blood pressure;Biochemical indicators: triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,total cholesterol,free fatty acid,h BA1 c,homocysteine,uric acid,fasting blood glucose,serum creatinine,urea nitrogen,24-hour urinary protein,urinary microalbumin,urinary creatinine.According to the UACR test values,the results are divided into: In the simple diabetic group（UACR<30mg/g）,the early diabetic nephropathy group（30mg/g≤UACR<300mg/g）,and the clinical diabetic nephropathy group（UACR≥300mg/g）,the correlation between the levels of TG/HDL-C and HCY and the index OF diabetic nephropathy（UACR）was analyzed.All the above data were analyzed and processed by SPSS25.0 software,and P < 0.05 indicated statistically significant differences.Result:1.Comparison of general data: The course of disease,age and SBP of CDKD group were significantly higher than that of SDM group（P <0.05）,and SBP of CDKD group was significantly higher than that of EDKD group（P < 0.05）.The course of disease in EDKD group was significantly higher than that in SDM group（P < 0.05）.2.Comparison of blood lipid and diabetes-related indexes among the three groups: Hb A1 c,FPG,TG and TG/HDL-C in EDKD group were significantly higher than those in SDM group（P < 0.05）,while TG,TC and TG/HDL-C in CDKD group were significantly higher than those in SDM group（P < 0.05）.3.Comparison of renal function indexes among the three groups（1）Compared with SDM group,SCr,UA,HCY and 24-hour urine protein were significantly increased in EDKD group（P < 0.05）;In CDKD group,SCr,BUN,UA,HCY and 24-hour urine protein were significantly increased（P < 0.05）,while e GFR was significantly decreased（P < 0.05）.（2）Compared with EDKD group,SCr,BUN,HCY and 24-hour urine protein quantification in CDKD group were significantly increased（P < 0.05）,while e GFR was significantly decreased（P < 0.05）.The levels of SCr,HCY and 24 urinary protein increased with the progression of UACR（P < 0.05）.4.Correlation analysis between UACR and various indicators:UACR was negatively correlated with e GFR（P < 0.05）,and positively correlated with age,course of disease,SBP,TG,TC,LDL-C,TG/HDL-C,SCr,BUN,UA,HCY and 24-hour urine protein quantification（P < 0.05）.5.Comparison of clinical indicators of SDM,EDKD and CDKD:Chi-square test of TG,TC,LDL-C and HCY stratified groups showed statistically significant differences（P < 0.05）.6.Binary multi-factor Logistic regression analysis: the elevation of FPG and HCY was correlated with whether diabetic nephropathy was present,and these indicators may be independent influencing factors of diabetic nephropathy.7.The area under curve（AUC）of TG/HDL-C for predicting the occurrence of diabetic nephropathy was 0.707（95%CI0.621-0.792）.When the maximum value of Yoden index was 0.404,the optimal cut-off point of TG/HDL-C was 1.45,and the corresponding sensitivity and specificity were 0.804 and 0.586,respectively.The area under the curve（AUC）predicted by HCY for DKD occurrence was 0.773（95%CI0.701-0.845）.When the maximum jorden index was 0.543,the optimal cut-off point of HCY was 13.805,and the sensitivity and specificity were0.643 and 0.897,respectively.The AUC of the combined test was 0.788（P< 0.001）with 95% confidence interval（0.717-0.859）.The sensitivity and specificity were 0.750 and 0.793 when the maximum Jorden index was0.543.Conclusion:1.TG/HDL-C and HCY levels were positively correlated with UACR;2.HCY was an independent risk factor for DKD,and TG/ HDL-C and HCY had good predictive value for the occurrence of DKD. |
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