Correlation Analysis Of Serum Lipid And Uric Acid Levels With The Risk Of Diabetic Kidney Disease Progression

Objective: In recent years,with the change of people’s lifestyle and dietary habits,the incidence of Diabetes Mellitus is increasing year by year.In addition to cardiovascular damage,the main cause of diabetes is Diabetic Kidney damage.Studies show that currently Diabetic Kidney disease is a frequent occurrence.In clinical practice,End Stage Renal Disease caused by DKD occupies the first place in clinical dialysis patients,so it is of definite clinical value to pay attention to and study DKD.Dyslipidemia,as one of the common complications of DKD,may play a role in the occurrence and development of renal lesions in diabetic patients.In recent years,the role of Serum Hyperuricemia level in the development of DKD disease is also a hot topic.Therefore,the purpose of this study was to explore the correlation between blood lipid and uric acid levels and the progression of DKD,and to evaluate the predictive value of blood lipid and uric acid levels on the risk of disease progression in patients with DKD,so as to provide theoretical basis for the clinical prevention and treatment of DKD.Methods: In this study,a total of 475 patients diagnosed with Type 2 Diabetes Mellitus during hospitalization at The First Affiliated Hospital of Wannan Medical College from September 2019 to September 2022 were collected,including 372 patients with concurrent diagnosis of DKD.And 103 patients(264 males and 211 females)who did not have kidney damage.Clinical data included gender,age,course of disease,height,weight,SBP,DBP and BMI.Laboratory indicators included: FBG,Hb A1 c,TC,TG,HDL,LDL,Cys-c,BUN,Scr,UACR,UA,and e GFR was calculated according to CKD-EPI formula.Result: There were statistically significant differences in age,disease course,DBP,height,weight,HDL,Scr and SUA between different genders(P < 0.05).Compared with females,men had higher levels of height,weight,e GFR and SUA,but lower levels of age and HDL.There were significant differences in age,course of disease,SBP,DBP,body weight,BMI,FBG,TC,TG,LDL,Cys-c,BUN,Scr,e GFR,UACR and SUA among different risk groups(P < 0.05).Among them,glucose metabolism indexes FBG,lipid metabolism indexes TC,TG,LDL,renal function indexes Cys-c,BUN,Scr,e GFR,UACR and blood uric acid level SUA showed a gradual increasing trend with the increasing risk of progression.Spearman correlation coefficients rs of progression risk grade and TC,TG,LDL,and UA were 0.339,0.290,0.365,and 0.506(P < 0.05),respectively,indicating that the progression risk grade of DKD was positively correlated with TC,TG,LDL,and SUA.That is,the increase of TC,TG,LDL and SUA is associated with the increased risk of progression of kidney disease,wherein TC,TG and LDL are weakly positively correlated with the risk of progression,and SUA is moderately positively correlated with the risk of progression.However,the risk of progression was not correlated with FBG,Hb Alc and HDL(P > 0.05).Spearman correlation coefficients rs of SUA and TC,TG and LDL were 0.192,0.251 and 0.254,respectively(P < 0.05).SUA was weakly positively correlated with TC,TG and LDL,but SUA was not correlated with HDL level(P > 0.05).Multiple ordered regression analysis showed that the progression risk level of DKD was related to the course of disease,SBP,TG,LDL and SUA(P < 0.05),the course of disease(OR=1.050,95%CI:1.024 ～ 1.076,P < 0.05),SBP(OR=1.013,95%CI: 1.001 ～ 1.025,P < 0.05),TG(OR=1.264,95%CI: 1.042 ～ 1.534,P < 0.05),LDL(OR=1.550,95%CI: 1.101 ～ 2.182,P < 0.05),SUA(OR=1.009,95%CI: 1.007 ～ 1.012,P < 0.05)were risk factors for increased risk of DKD progression.ROC curve analysis results showed that the AUC of TC predicting the increased risk of DKD progression was 0.683(95%CI: 0.633 ～0.732,P < 0.05),the corresponding truncation value was 4.590,the sensitivity was54.9%,and the specificity was 76.7%.The AUC of increased risk of DKD progression predicted by TG was 0.663(95%CI: 0.614-0.713,P < 0.05),and the corresponding truncation value was 1.775,the sensitivity was 54.4%,and the specificity was 71.5%.HDL predicted that the AUC of increased risk of DKD progression was 0.555(95%CI:0.502-0.607,P < 0.05),the corresponding truncation value was 1.255 when the Yoden index was at its maximum,the sensitivity was 54.9%,and the specificity was 58.1%.LDL predicted the increased risk of DKD progression with 0.677 AUC(95%CI: 0.628-0.726,P < 0.05),and the maximum Yoden index corresponding truncation value was2.235,sensitivity 67.6%,specificity 59.3%.SUA predicted an AUC with an increased risk of DKD progression of 0.754(95%CI: 0.710-0.798,P < 0.05),a truncation value of 350.15 for the maximum Yoden index,a sensitivity of 60.3%,and a specificity of81.5%.Conclusion: 1.In DKD patients,men had higher e GFR and SUA levels,and lower age and HDL;2.The levels of TC,TG,LDL and SUA were positively correlated with the risk of DKD progression;3.In DKD patients,the levels of TC,TG and LDL were positively correlated with SUA levels;4.Course of disease,SBP,TG,LDL and SUA were risk factors for the increased risk of DKD progression;5.The predictive significance of SUA on the progression of DKD was higher than that of TC,TG,HDL and LDL.