Study On The Changes Of MHR And α1-MG And Their Clinical Significance In Patients With DKD In Qinghai

Objective: In this paper,the changes of Monocyte/high-density lipoprotein ratio(MHR)and urine alpha1-microglobulin(α1-MG)in diabetic kidney disease(DKD)and their correlation with urinary albumin-to-creatinine ratio(UACR)in type 2 diabetic patients(T2DM)in Qinghai area were investigated to explore the diagnostic value of MHR and urine α1-MG in DKD patients with kidney injury.Methods: A total of 255 T2 DM patients with complete data and meeting the inclusion and exclusion criteria who visited our endocrinology department from November 2019 to October 2021 were selected and divided into the following groups according to the UACR ratio: simple diabetes group,early diabetic kidney disease group and the clinical diabetic kidney disease group.The general data and study indicators were collected including monocyte count(Mono),hemoglobin(Hb),hematocrit(Hct),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),serum creatinine(Scr),serum cystatin C(Cys C),fasting blood glucose(FBG),glycated hemoglobin A1c(Hb A1c),α1-MG,24-hour urine protein quantification,and calculation of MHR(MHR=M/HDL-C)and e GFR values were collected and perform statistical analysis using statistical software.Results:(1)The general statistical data comparison results of patients between the three groups showed no statistical significance in gender,age,and BMI among the three groups(P>0.05),As the disease progressed,patients’ blood pressure among the three groups showed an upward trend,and there was statistical significance(P<0.05).the comparative results of the study data between the three groups showed that there were statistically significant differences in the quantitative values of FBG,Mono,MHR,BUN,Scr,UA,e GFR,Cys C,diabetes course,urine α1-MG and urine protein(P<0.05),there were no significant differences in Hb,Hct,TC,TG,HDL-C,LDL-C and Hb A1c(P>0.05).(2)Spearman correlation analysis of UACR with MHR and urine α1-MG showed a moderate positive correlation between UACR and MHR(rs=0.495)and a moderate positive correlation with urine α1-MG(rs=0.531)(P<0.05).(3)Using UACR>30mg/g as the threshold for diagnosing DKD,ROC curve analysis was performed to evaluate the predictive efficacy of the observed indexes.The results showed that the optimal cut-off point of MHR was 0.351,and the area under the curve was 0.811(95% confidence interval: 0.757-0.865,P<0.01),the Youden index was 0.476,the sensitivity was 73.5%,and the specificity was 74.1%.The optimal cutoff point of urine α1-MG was 14.45 mg/L,the area under the curve was 0.745(95%confidence interval: 0.685-0.806,P<0.01),the Youden index was 0.371,the sensitivity was 61.8%,and the specificity was 75.3%.The area under the curve for the combined prediction of renal damage was 0.847(95% confidence interval: 0.799-0.894,P<0.01),and its Youden index was 0.529,the sensitivity was 81.2%,and the specificity was71.8%.Conclusion:(1)MHR,urine α1-MG increased with the progression of DKD.(2)MHR and urine α1-MG can be used as a simple indicator to initially determine the severity of disease in patients with DKD.