Analysis Of Related Factors Of Dyslipidemia And Distribution Of TCM Syndrome Types In CKD Stage 3-5 Non-dialysis Patient

Objective: By studying the clinical symptoms and laboratory indices of nondialysis combined with dyslipidemia in patients with chronic kidney disease(CKD)stages 3-5,we analyze the factors involved in the disease and their correlation with clinical indices for early prevention and treatment of combined dyslipidemia in CKD,to explore the distribution pattern of their traditional Chinese Medicine(TCM)syndrome type evidence,and to provide reference for their TCM identification.Methods: In a single-center,cross-sectional study,158 non-dialysis patients with CKD stage 3-5 admitted of the Hospital of Liaoning University of traditional Chinese Medicine from December 2021 to December 2022 were recruited.The patients were divided into a dyslipidemia group and a non-dyslipidemia group according to the presence or absence of dyslipidemia,with 94 patients in the dyslipidemia group and 64 patients in the non-dyslipidemia group.General data such as age,sex,height,weight,and past medical history of the patients were collected retrospectively.The laboratory indices of patients after admission were collected,including serum creatinine(Scr),estimated glomerular filtration rate(e GFR),albumin(ALB),blood urea nitrogen(BUN),total cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),uric acid(UA),hemoglobin(Hb)and the information of the four diagnoses of TCM.The data were statistically analyzed using SPSS25.0 software to explore the factors associated with combined dyslipidemia in non-dialysis patients with CKD stage 3-5 and the distribution characteristics of TCM evidence patterns.Results:1.General analysis: 158 non-dialysis patients with CKD stages 3-5 were included,including89(56%)males and 69(44%)females.158 patients with CKD stage 3-5 had 30 cases with CKD stage 3 totally,of which 17 were combined with dyslipidemia,82 cases with CKD stage4,of which 49 were combined with dyslipidemia,and 46 cases with CKD stage 5,of which28 were combined with dyslipidemia.The prevalence of dyslipidemia was not statistically different among the stages(P>0.05).2.Comparative analysis between the dyslipidemia group and the non-dyslipidemia group:there was a significant difference between the BMI of the two groups,and the difference was statistically significant(P<0.01),there was no statistical difference in gender,age,prevalence of primary kidney disease,prevalence of diabetes and prevalence of hypertension(P>0.05).There was no statistically significant difference between the two groups in Hb,ALB,Scr,UA,BUN and e GFR indexes(P>0.05),CRP levels were higher in the dyslipidemic group than in the non-dyslipidemic group,and the difference was statistically significant(P<0.05).3.Comparative analysis between groups with different lipid characteristics in the dyslipidemia group: 94 patients in the dyslipidemia group were divided into three groups according to lipid parameters,namely,the high triglyceride(HTG)group,the low high density lipoprotein(LHDL)group and the mixed hyperlipidemia(CH)group,in which 39 cases(41.5%)in the HTG group,33 cases(35.1%)in the LHDL group and 22 cases(23.4%)in the CH group.The differences between the three groups in BMI were statistically significant(P<0.05),and there were no statistical differences in gender and age(P>0.05),the differences between the three groups in ALB,UA,CRP,BUN,and e GFR indexes were not statistically significant(P>0.05),and the differences in Scr levels were statistically significant(P<0.05),the Hb levels in the LHDL group were lower than those in the HTG and CH groups,and the differences were statistically significant(P<0.01).4.Characteristics of dyslipidemia in patients with different stages of CKD: HTG combined with LHDL is the main dyslipidemia in CKD,and the number of LHDL patients increases more obviously with the progress of CKD.5.Analysis of factors affecting dyslipidemia in CKD: TG level was positively correlated with Hb,ALB and e GFR levels,and negatively correlated with Scr and BUN levels.TC level was positively correlated with Hb and e GFR levels,and negatively correlated with Scr levels.HDL-C level was positively correlated with e GFR levels,and negatively correlated with Hb and Scr levels.LDL-C was negatively correlated with UA and CRP levels negative correlation.Multiple linear regression analysis showed that TG level was positively correlated with Hb and negatively correlated with Scr.TC level was negatively correlated with Scr.HDL-C level was negatively correlated with Hb and Scr.LDL-C level was negatively correlated with CRP.6.Distribution of TCM evidence types: 58 cases with the highest proportion(36.7%)were spleen and kidney qi deficiency,54 cases(34.2%)were spleen and kidney yang deficiency,19cases(12.0%)were yin and yang deficiency,16 cases(10.1%)were qi and yin deficiency,and11 cases(7.0%)were liver and kidney yin deficiency.The highest proportion of cases was 65cases(41.1%)with dampness and turbidity,55 cases(34.8%)with stasis of blood,29cases(18.4%)with damp-heat,and 9 cases(5.7%)with heat toxicity.In each stage of CKD 3-5,the distribution of this evidence and the standard evidence showed similar patterns,and no significant statistical differences were observed(P>0.05).In the dyslipidemia group,there were most cases of spleen and kidney qi deficiency(42.6%),and in the non-dyslipidemia group,there were most cases of spleen and kidney yang deficiency(39.1%),and there was no statistically significant relationship between this evidence and the combination of dyslipidemia(P>0.05).In the standardized evidence,the largest number of patients with dampness and turbidity evidence in the dyslipidemia group accounted for 50%,and the largest number of patients with stasis and blood stasis evidence in the non-dyslipidemia group accounted for 45.3%,and there was a statistically significant difference between the standardized evidence and whether the dyslipidemia was combined or not(P<0.05).Conclusions:1.the combined dyslipidemia in non-dialysis patients with CKD stage 3-5 is dominated by high TG combined with low HDL,and the number of patients with low HDL increases with the course of CKD disease.2.BMI,CRP,Hb,Scr and other indicators are associated with CKD combined with dyslipidemia,and the clinic should monitor the relevant indicators and implement intervention as early as possible.3.CKD stage 3-5 non-dialysis patients with combined dyslipidemia have the most evidence of spleen-kidney qi deficiency and are often accompanied by dampness and turbidity.