Correlation Of Serum Retinol-binding Protein,Homocysteine,Blood Lipids And Urine ACR In Patients With Type 2 Diabetes Mellitus

Objective To investigate the correlation of serum retinol-binding protein,homocysteine,blood lipids and urine ACR in patients with type 2 diabetes mellitus.Methods A total of 856 T2 DM patients（536 males and 320 females）who were hospitalized in the Endocrinology Department of the Third Affiliated Hospital of Bengbu Medical College from September 2019 to September 2021 were selected.All patients were divided into 3 groups according to the urine microalbumin/creatinine ratio（urine ACR）: simple diabetes group: urine ACR<30mg/g;early diabetic nephropathy group: 30 mg/g≤urine ACR<300mg/g;clinical diabetic nephropathy Group: Urine ACR≥300mg/g.Baseline data such as gender,course of disease,age,body mass index,and retinol-binding protein,homocysteine,creatinine,urea,fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,and low-density lipoprotein were compared among the three groups.,high-density lipoprotein and other serological indicators.Pearson correlation analysis was applied to analyze bivariate correlations between urinary ACR and other indicators.The receiver operating characteristic curve（ROC curve）was used to analyze the diagnostic efficacy and optimal thresholds of RBP and Hcy for diabetic kidney disease（DKD）.P<0.05 means the difference is statistically significant.Results 1.Comparison of the general clinical data of the three groups of patients:There was no significant difference in FBG and Hb A1 c among the three groups（P>0.05）,but there were statistical differences in BMI,age,and course of disease among the three groups（P<0.05）.The BMI of diabetic nephropathy group was higher than that of simple diabetes group,and the difference was statistically significant（P<0.05）.The course of disease in the early diabetic nephropathy group and the clinical diabetic nephropathy group was longer than that in the simple diabetes group,and the difference was statistically significant（P<0.05）.The age of the early diabetic nephropathy group was higher than that of the simple diabetes group,and the difference was statistically significant（P<0.05）.2.Comparison of blood lipids among the three groups of patients: There were statistically significant differences in LDL,HDL,and TC among the three groups of patients（P<0.05）,the pairwise comparison between the groups indicated that the LDL and TC in the clinical diabetic nephropathy group were higher than those in the simple diabetes group and the early diabetic nephropathy group,and the difference was statistically significant（P<0.05）.3.Comparison of renal damage indicators among the three groups: Cr,BUN,RBP,and Hcy in the clinical diabetic nephropathy group were higher than those in the simple diabetes group and the early diabetic nephropathy group,and the difference was statistically significant（P<0.05）.BUN,RBP and Hcy were higher than those in the simple diabetes group,and the difference was statistically significant（P<0.05）.4.Comparison of the correlation between urine ACR and various serological indexes:pearson correlation analysis showed that urine ACR was positively correlated with RBP,Hcy,BUN,Cr,and the correlations were r=0.522,r=0.380,r=0.366,r=0.377（P<0.05）.Urine ACR was positively correlated with LDL and TC（r=0.244,r=0.259,P<0.05）.5.ROC curve results: the critical value of RBP for diagnosing DKD is 50.5 mg/L,the sensitivity is 52.0%,the specificity is 84.9%,the critical value of Hcy for diagnosing DKD is 11.5 μmol/L,the sensitivity is 71.0%,and the specificity is 59.8%.Conclusions 1.This study showed that with the progression of T2 DM patients,the levels of RBP and Hcy gradually increased,and the urine ACR was positively correlated with RBP and Hcy.The ROC curve results showed that the critical value of RBP for diagnosing DKD was 50.5 mg/L,and Hcy was used to diagnose DKD.The critical value of DKD is 11.5μmol/L.RBP and Hcy are of great value in the early diagnosis and disease evaluation of DKD.2.This study shows that urine ACR is positively correlated with the levels of LDL and TC.In DKD patients,with the progression of the disease,the levels of LDL and TC gradually increase.Monitoring blood lipid levels such as LDL and TC is of great significance for evaluating the disease progression of DKD patients.