Study On The Correlation Between Monocyte/high-density Lipoprotein And Chronic Kidney Disease Stages And Syndrome Factor

Objective:1.Explore the correlation between the Monocyte to High-Density Lipoprotein Ratio(MHR)and Chronic Kidney Disease(CKD),and analyze the clinical diagnostic value of MHR for CKD;2.Observe the common symptoms and distribution characteristics of syndrome elements in CKD patients,and explore the impact of relevant clinical indicators on syndrome elements.Methods:A total of 132 patients with chronic kidney disease who were hospitalized in the Nephrology Department of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from January 2018 to December 2022 were studied,and 132 healthy individuals matched in age and gender at the physical examination center of our hospital during the same period were used as the control group.Collect general information and laboratory indicators,compare basic data and related clinical indicators(kidney function,blood routine,blood lipids,fasting blood glucose,etc.)between the two groups,and explore the correlation between MHR and laboratory indicators through Spearman rank correlation analysis.Using logistic regression analysis to explore independent risk factors for the onset of CKD.The clinical diagnostic value of MHR in CKD was analyzed using the receiver operating characteristic(ROC)curve.Collect traditional Chinese medicine diagnostic data of CKD patients,observe their common clinical symptoms and distribution characteristics of syndrome elements,and explore the correlation between clinical indicators and syndrome elements.Results:1.This study included 132 CKD patients,including 81 males and 51 females,with a median age of 59(50,66)years.There were 132 health examinees.including 79 males and 53 females,with a median age of 58.5(47,65)years.The MHR of CKD patients was significantly higher than that of healthy individuals(P<0.05).but as the degree of kidney injury increased,there was no difference in MHR among CKD patients in different stages(P>0.05).2.MHR is positively correlated with inflammatory markers such as hypersensitive Creactive protein(r=0.478,P=0.000),white blood cells(r=0.667,P=0.000),neutrophils(r=0.611,P=0.000),and lymphocytes(r=0.201,P=0.000)(P<0.05).3.Using multivariate logistic regression analysis to explore the risk factors of CKD,the results showed that serum albumin decreased(OR=0.621,95%CI=0.501-0.769,P=0.000),serum creatinine increased(OR=1.084,95%CI=1.043-1.127,P=0.000),fasting blood glucose increased(OR=2.451,95%CI=1.106-5.433,P=0.027)Elevated MHR(OR=8.881,95%CI=2.242-35.173,P=0.002)and elevated systolic blood pressure(OR=1.128,95%CI=1.0501.212,P=0.000)are independent risk factors for the occurrence of CKD.The ROC curve was used to evaluate the clinical diagnostic value of MHR for CKD:the area under the curve(AUC)was 0.847(95%CI:0.800-0.895,P=0.000),the maximum Jordan index was 0.553,the optimal cutoff value was 0.315,the sensitivity was 72.7%,and the specificity was 82.6%.The predictive AUC of MHR diagnosis for early CKD is 0.839(95%CI:0.768-0.910,P=0.000),with a maximum Jordan index of 0.530,an optimal cutoff value of 0.355,a sensitivity of 66.7%,and a specificity of 86.4%.Elevated MHR has certain diagnostic value for predicting CKD disease,but its sensitivity to early diagnosis is not high.4.The combination of deficiency and excess syndrome(65.91%)is the most common component of traditional Chinese medicine syndrome,followed by simple deficiency syndrome(26.52%),and the combination of simple excess syndrome(6.06%)and asymptomatic syndrome(1.51%)is the least common.The combination of deficiency and excess syndrome is more common in Qi deficiency+water dampness syndrome(26.52%),Blood deficiency+water dampness syndrome(15.91%),and Qi deficiency+dampness turbidity syndrome(15.91%).Among the elements of deficiency syndrome.Qi deficiency syndrome(69.92%)is the most common,followed by blood deficiency syndrome(49.62%).and Yang deficiency syndrome(35.34%)and Yin deficiency syndrome(21.80%)are the least common:Among the elements of solid syndrome.water dampness syndrome(37.59%)is the most common,followed by dampness heat syndrome(22.56%)and blood stasis syndrome(21.8%),and dampness turbidity syndrome(19.70%)is the least common.Among the disease location syndrome elements,the kidney(83.46%)is the most common,followed by the spleen(54.89%),lungs(51.13%),and heart(62 cases,46.62%),and the liver(19.55%)is the least common.5.Logistic regression analysis was used to explore the relationship between various syndrome elements and clinical indicators.The results showed that MHR was not a risk factor for syndrome element formation,while decreased serum albumin(OR=0.945,95%CI:0.9020.990,P=0.017)was an independent risk factor for water dampness syndrome,and increased urea nitrogen(OR=1.186,95%CI:1.060-1.326,P=0.003)was an independent risk factor for dampness turbidity syndrome.Conclusion:1.Elevated MHR is an independent risk factor for the occurrence of CKD,and M HR can serve as an independent predictor of CKD.MHR has certain diagnostic value for the early onset of CKD,but its sensitivity is not high.2.MHR is correlated with inflammatory indicators such as WBC,NEUT,LYM an d hsCRP.3.The main location of CKD patients is in the kidney,which is closely related to the spleen,lungs,and heart.Qi deficiency is the most common type of deficiency sy ndrome,while water dampness is the most common type of solid syndrome.CKD pat ients are mainly characterized by a combination of deficiency and excess,with Qi defi ciency combined with water dampness being the most common.4.There is no significant correlation between MHR and syndrome elements,but a decrease in ALB is an independent risk factor for water dampness syndrome,and an i ncrease in BUN is an independent risk factor for dampness turbidity syndrome.