The Relationship Between Diabetic Nephropathy And Liver Enzymes

Objective:In this research we investigate the relevancy between serum liver enzyme alanine aminotransferase, aspartate aminotransferase, glutamyl GGT level and diabetic nephropathy. The research include the following aspects. First of all, to collect information on the level of patients’s liver enzymes in in endocrinology and nephrology department of YANBIAN hospital. Secondly, to determine whether serum liver enzymes indexes is valuable to the diagnosis of early diabetic nephropathy, as we can initial the observation analysis on suspected patients. Furthermore, The correct analysis on the three important indicators of liver index is helpful in diagnosis of early diabetic nephropathy. such analysis is important to take early observations and interventions to the people who is at high risk. It also can prevent the complications of kidney disease and provide a new evidence for treatments of diabetic nephropathy. We collect 274patients with type 2 diabetes and diabetic nephropathy in endocrinology who don’t suffer from Hepatitis A, hepatitis B, fatty liver disease and other complications of liver diseases which contains 125 males and 149 females from nephrology department of YANBIAN hospital from January 2012 to January 2013. clinical data:We collect and organize basic information of patients, which include their serial numbers, names, sex, ages, diabetes durations, Systolic Blood Pressures (SBP) and Diastolic Blood Pressures (DBP). Furthermore, we extract the fasting venous blood of patients in order to test and collect the data of total cholesterol (TC) triglyceride, (TG)、high-density lipoprotein cholesterol, (HDL-c)、 low-density lipoproteincholesterol, (LDL-c), uric acid, (UA)、glucose, (GLU)、 aspartate aminotransferase, (AST)、alanine amiotransferase, (ALT)、gamma glutamyltransferase, (GGT)、creatinine, Cre and urinary albumin excretion rates, UAER.We divided our sample into three groups based on the level of urine trace albumin excretion rate (UAER). The DM group (simple diabetes group):UAER< 30 mg/24h, DN 1 group (early diabetic nephropathy group):30 mg/24h≤ UAER< 300 mg/24h and DN2 group (clinical diabetic nephropathy group):UAER≥300 mg/24h.Results:The descriptive results of three groups,The sample data among the three groups of diabetic nephropathy with disease progression, duration, TC, GLU, GGT, ALT, serum cystatin c aspects shows statistically significance. Specifically, the level of duration, the value of GGT are increasing along from the none nephropathy group to clinical diabetic nephropathy group. The value of GLU and ALT also show an increasing trend from DM group to DN1 group, however, the figures of DN2 group are smaller than the frist two group, yet they all are statistically significance.:The relationship between different AST, ALT, GGT levels and the level of diabetic nephropathy, abnormal blood pressure, blood lipids, blood glucose, uric acid.The prevalence of diabetic nephropathy, hypertension prevalence, prevalence of high total cholesterol, high triglycerides prevalence increases with glutamyl endopeptidase quintile values rise. The correlation between the level of diabetic nephropathy and indexes.The extent of kidney damage of diabetic was positively correlated with GGT levels, the correlation coefficients is 0.262. The P-value are less than 0.05 which means they are statistically significant. ALT and extent of kidney damage in diabetic patients was negatively correlated with a correlation coefficient of -0.167 (P<0.05) there was statistically significant. A logistic regression analysis on type 2 diabetic nephropathy and GGT, ALT, AST.We run a logistic stepwise regression analysis on our sample. We made the incidence of nephropathy (0 for no,1 for there) as dependent variable and GGT, ALT, AST independent variables. We find out that GGT is an independent risk factor for type 2 diabetic nephropathy.Conclusion:The level of GGT is closely related to multiple indicators of diabetic nephropathy, when the level of GGT rise 5 points, the incidence of diabetic nephropathy will increase. GGT is the independent risk factors of diabetic nephropathy. We conclude that GGT can not only be used as a biological index of the liver and gallbladder diseases and involved in the pathogenesis of diabetic nephropathy and diabetes, but also can provide a new evidence and development for the prevention and treatment of diabetic nephropathy. In this research, AST and ALT are not associated with diabetic nephropathy which needs to be studied further.