Correlation Study Of Combined Platelet Parameters,Lp(a),FIB Assay,and Type 2 Diabetic Kidney Disease

Objective: In this study,we investigated the levels between platelet parameters,Lipoprotein a(Lp(a)),and,Fibrinogen(FIB)in type 2 diabetes mellitus(T2DM)patients.The correlation between platelet parameters,Lp(a),FIB,and the combined test and diabetic kidney disease(DKD)was investigated.Methods: From October 2020 to December 2022,257 inpatients with T2 DM with or without DKD in the Affiliated Hospital of Guilin Medical College were selected,and the study subjects were divided into simple T2 DM group and DKD group according to whether DKD was combined or not,and then the DKD group(urinary albumin to urinary creatinine ratio(UACR)of DKD patients collected in this study were ≥30 mg/g)was divided into microproteinuria group and massive proteinuria group according to UACR.The general data and laboratory test results of the study subjects were collected,and the body mass index(BMI),estimated glomerular filtration rate(e GFR),and estimated creatinine ratio(UACR)were calculated.Platelet parameters were compared: Platelet count(PLT),platelet distribution width(PDW),mean platelet volume(MPV),platelet specific volume(PPCR),and platelet volume(MPV).The differences in platelet distribution width(PDW),mean platelet volume(MPV),platelet volume(PCT),platelet large cell ratio(P-LCR),Lp(a),and FIB between different groups were evaluated by logistic regression analysis to assess the risk factors for concomitant DKD in T2 DM patients,and the ROC curves were used to evaluate platelet parameters,Lp(a),and FIB.(a),and FIB was used to evaluate the predictive value of platelet parameters,Lp(a),and FIB in T2 DM patients with concurrent DKD,and Spearman correlation analysis was used to understand the correlation between risk factors and the severity of DKD in T2 DM patients with concurrent DKD.Result(s): 1 Compared with the T2DM-only group,the age difference,duration of diabetes,and duration of hypertension in the DKD group were statistically significant(P<0.05);compared with the T2DM-only group,the differences in PLT,PDW,MPV,P-LCR,FIB,Lp(a),e GFR,BUN,UA,and Cys-C levels in the DKD group were statistically significant(P<0.05).That is,the levels of PLT,FIB,Lp(a),BUN,UA,and Cys-C were significantly higher in the DKD group;the levels of PDW,MPV,P-LCR,and e GFR were significantly lower in the DKD group.2.Compared with the microproteinuria group,the differences in the levels of FIB,Ln(Lp(a)),e GFR,BUN,Cys-C,and Ln(Scr)in the massive proteinuria group were statistically significant(P<0.05),and PLT,PDW,MPV,P-LCR,UA were not statistically significant between the two groups(P>0.05).3.Univariate analysis suggested that PLT,PDW,MPV,P-LCR,FIB,and Lp(a)were statistically significant between the T2DM-only group and the DKD group(P<0.05).e GFR was positively correlated with PDW,UACR,Scr,and Cys-C were negatively correlated with PDW;UACR was negatively correlated with MPV;UACR,DR lesion,history of hypertension,Scr,BUN,UA,and Cys-C were positively correlated with FIB,and e GFR was negatively correlated with FIB;UACR,DR lesion,Scr,BUN,UA,and Cys-C were positively correlated with Lp(a).4.Binary logistic analysis showed that PLT,PDW,MPV,P-LCR,FIB,and Lp(a)were correlated with T2 DM comorbid with DKD,and analysis after correcting for age,sex,duration of diabetes,and history of hypertension showed that PDW,FIB,and Lp(a)were still correlated with DKD comorbid with T2 DM patients,(OR=0.846.95%CI:0.737-0.971,P<0.05),(OR=3.654,95%CI:2.364-5.618,P<0.05),(OR=1.015,95%CI:1.003-1.026,P<0.05).5.ROC curve analysis showed that the area under the curve(AUC)of PDW predicting T2 DM with DKD was 0.385(95%CI:0.316-0.454.P<0.05)The threshold value of FIB for predicting T2 DM with DKD was 2.905 g/l(sensitivity: 72.7%,specificity 72.9%),the AUC was 0.776(95%CI:0.720-0.833,P<0.05),the threshold value of Lp(a)for predicting T2 DM with DKD was 10.5 mg/dl(sensitivity: 54%,specificity: 60.2%)with an AUC of0.577(95%CI: 0.508-0.647,P<0.05).the combined test of PDW,FIB,and Lp(a)predicted DKD in patients with T2 DM,showing an AUC of 0.780(95%CI:0.724-0.836,P<0.05)for the combined test.0.836,P<0.05),with a sensitivity of66.2% and specificity of 82.2% for predicting that patients with T2 DM will have concurrent DKD.Conclusions: 1.PLT,PDW,MPV,P-LCR,FIB,and Lp(a)are associated with T2 DM complicated by DKD.2.The combination of PDW,FIB,and Lp(a)has some predictive value for T2 DM complicated by DKD.