Analysis Of The Risk Factors Of Renal Function Decline In Type 2 Diabetes Mellitus Patients

Objective To investigate the risk factors of renal function decline in type 2diabetes mellitus patients,to provide evidence for clinical prevention and treatment.Methods 5043 patients of type 2 diabetes were included in the study,according to the estimated glomerular filtration rate(eGFR),patients were divided into eGFR <60 and eGFR ?60 groups.Demographic data and biochemical examination between different groups were compared.The incidence rate of eGFR <60 were compared after stratify the risk factors.To analyze the relationship between risk factors control and renal function decline.Relationship between eGFR and other clinical indicators were analyzed by Pearson or Spearman correlation.Using binary logistic regression analyze the risk factors for eGFR decline.Results Compared with eGFR ?60 group,patients in the eGFR <60 group are older[(64.67±10.16)year vs(57.00±10.31)year,P <0.01],and undergo longer duration of diabetes{[12.00(7.00,18.00)] year vs [5.00(2.00,10.00)] year,P <0.01},also proportion of diabetes family history(62.15% vs 29.22%,X~2 =342.010,P<0.01),prevalence of hypertension(78.47% vs 47.02%,X~2 =283.953,P <0.01)and prevalence of arteriosclerosis(63.19% vs 37.83%,X~2 =188.843,P <0.01)increased.The incedence of eGFR<60 increased with older age(X~2=397.534,P <0.01),longer duration of diabetes(X~2=398.968,P < 0.01),higher 24 h urine protein level(X~2=1840.510,P <0.01),diabetes family history positive(X~2=338.481,P<0.01),hypertension positive(X~2=283.953,P <0.01),arteriosclerosis positive(X~2=188.843,P <0.01)and hyperuricemia positive(X~2=566.289,P <0.01).The renal function decline were not obviously related to the strict control of blood sugar,blood pressure,and blood lipid.Correlation analysis showed that eGFR was negatively correlated with age(r =-0.573,P < 0.01),duration of diabetes(r =-0.353,P <0.01),systolic pressure(r =-0.176,P < 0.01),24 h urine protein(r =-0.438,P <0.01),serum uric acid(r =-0.214,P < 0.01)?homocysterine(r =-0.245,P <0.01).Binary logistic regression analysis prompted that age,duration of diabetes,family history of diabetes,24 h urine protein and serum uric acid were independent risk factors for eGFR decline.[OR =1.100,95%CI(1.080,1.120),P < 0.01;OR =1.078,95%CI(1.054,1.104),P < 0.01;OR =3.829,95%CI(2.762,5.309),P < 0.01;OR =3.175,95%CI(2.773,3.636),P < 0.01;OR =1.012,95%CI(1.011,1.014),P < 0.01]?Conclusion Age,duration of diabetes,family history of diabetes,24 h urine protein and serum uric acid are independent risk factors for renal function decline in patients of type 2 diabetes mellitus.