The Research Of The Relationship Between Urinary ACE2 Concentrations And Early Renal Damage In Patients With Hypertension And Hypertension Associated With Type 2 Diabetes Mellitus

Objective To investigate the correlation between urinary ACE2 concentrations and hypertension or combined diabetes.Further more,to explore whether urinary ACE2 can be a independent predictor of early renal damage in hypertension or combined diabetes.Methods 82 cases of patients which was divided into two groups included hypertension group and hypertension combined diabetes group were selected continuously from the Department of Cardiology of the First Affiliated Hospital of Fujian Medical University from Dec.2016 to Mar.2017 by cross-sectional study method.Selected another 28 cases of non-atrial fibrillation as control matched for sex,age and comorbidities.Recorded all subjects of clinical data detailedly,including,sex,age,height,weight,BMI,Uric acid,Serum creatinine,Glomerular Filtration Rate,Triglyceride,Totalcholesterol,High-density lipoprotein,Low density lipoprotein,microalbuminuria,echocardiography ucg and urinary ACE2 concentrations,and to compare the indicators among these groups.Results?1?There were no significant differences in sex,age,BMI,drink,stroke,smoking,the hypertension duration and drug therapy among above groups?P> 0.05?.The difference of urinary ACE2 concentrations between ACEI/ARB used and ACEI/ARB nonused in hypertension group or combined diabetes group make no sence.?2?There were statistical significant differences in urinary ACE2 concentrations among control group,hypertension group and hypertension combined diabetes group.?mean value : 1134.20±129.00 VS 1484.25±205.23 VS 1265.61±213.65,P<0.01?.?3?The urinary ACE2 concentrations correlated positively with microalbuminuria in hypertension group?r=0.57,P=0.001?and combined diabetes group.?r=0.50,P=0.001?.?4?Multivariate Logistic regression analysis showed that: urinary ACE2 concentrations was independent predictor for early renal damage in hypertension group(OR,1.01,95% CI,1.00¹.01,P_{Urinary ACE2}=0.01).Urinary ACE2 in predicting the area under the curve of early renal damage is 0.77?95% CI = 0.55⁰.99,P =0.024<0.05?,the sensitivity and specificity were 85.7% and 76.5%.Multivariate Logistic regression analysis showed that: urinary ACE2 concentrations was independent predictor for early renal damage in hypertension combined diabetes group group(OR,1.01,95%CI,1.00¹.01,P_{Urinary ACE2}=0.01).Urinary ACE2 in predicting the area under the curve of early renal damage is 0.83?95% CI = 0.55⁰.99,P <0.05?,the sensitivity and specificity were 75% and 84.8%.Conclusion The level of urine ACE2 was positively associated with early renal impairment in hypertension and was a predictor of early renal impairment.The level of urine ACE2 was positively associated with the early renal impairment with hypertension associated with type 2 diabetes mellitus,and could be used as a predictor of early renal impairment.