Study On The Correlation Between The Content Of Uric Acid In Type 2 Diabetic Nephropathy And Blood

Objective: To investigate the relationship between blood urinary acid and type 2 diabetic nephropathy(T2DKD)in patients with type 2 diabetes mellitus(T2DM).Methods: 500 patients with type 2 diabetes mellitus(T2DM)were selected,including 247 males and 253 females,aged 26-93 years old,who were excluded from the group according to the exclusion criteria.According to blood uric acid level,male >420umol/L,female >350umol/L,postmenopausal women with male uric acid,divided into hyperuricemia group(HUA)and 235 cases of normal uric acid group(NUA)265 cases;according to urinary albumin excretion rate(UAER)for urinary albumin excretion rate(UAER<20ug/min)and normal group(UAER1 group),217 cases early diabetic nephropathy(UAER20-200ug/min)group(UAER2 group)and 204 cases of clinical nephropathy group(UAER>200ug/min)(UAER3 group)79 cases;according to the estimated glomerular filtration rate(eGFR)were divided into CKD1 group(eGFR = 90ml/min.1.73m2)256 cases,group CKD2(eGFR60-89ml/min.1.73m2)191 cases,group CKD3(eGFR30-59ml/min.1.73m2)53 cases,respectively.In the recording of the patient’s age,duration,gender,family history,blood determination of glycosylated hemoglobin(HbA1c),uric acid(URIC),fasting blood glucose(FBG),high density lipoprotein(HDL),TC(total cholesterol),low density lipoprotein(LDL),TG(triglyceride),blood creatinine(SCr),alanine aminotransferase(ALT)and aspartate aminotransferase(AST),systolic blood pressure(SBP),diastolic blood pressure(DBP),and calculate the urinary albumin excretion rate(UAER),body mass index(BMI)and insulin resistance index(HOMA-IR),estimated glomerular filtration rate(eGFR)and other indexes.To compare the differences of clinical data between HUA group and NUA group,the difference of urinary albumin excretion rate in normal group,early nephropathy group and clinical nephropathy group,and the difference of clinical data between CKD1 group,CKD2 group and CKD3 group.Results: HUA group of course,urinary protein excretion rate,TG,BMI,serum creatinine,systolic blood pressure,alanine aminotransferase,aspartate aminotransferase were higher than those of the NUA group(P < 0.05),glomerular filtration rate estimation value is lower than the NUA group(P < 0.05).Age,HbA1 c,TC,HOMA-IR,diastolic blood pressure of clinical data compared with no significant difference(P > 0.05).Age,course of disease,TC,TG,LDL,BMI,SCr,uric acid,SBP,DBP,AST and EGFR in UAER1,UAER2 and UAER3 have significant differences between the three groups(P<0.05);UAER2 group and UAER3 group in age,DBP higher than that of UAER1 group(P<0.05),age,DBP had no statistical significance between UAER2 and UAER3 group;increased duration,uric acid,BMI,SCr,SBP in UAER1 group,UAER2 group and UAER3 group were(P<0.05),EGFR in the UAER1 group,UAER2 group,UAER3 group showed a decreasing trend(P<0.05);UAER3 group of TC,TG,LDL higher than that of UAER1 group and UAER2 group(P<0.05),but in between UAER1 and UAER2 group showed no significant difference;UAER3 group ALT and AST was higher than that of UAER1 group(P<0.05),but in UAER1 group,UAER2 group showed no significant difference;high density lipoprotein,insulin resistance index and no significant difference between the three groups in glycated hemoglobin(P>0.05).Age,disease duration,urinary protein excretion rate,total cholesterol,low density lipoprotein cholesterol,uric acid,BMI,serum creatinine,systolic blood pressure,diastolic blood pressure,in the CKD1 group,CKD2 group,CKD3 group,have significant differences between the three groups(P<0.05);Age,duration of disease,urinary protein excretion rate,uric acid,body mass index(BMI),serum creatinine and increased with the increase of CKD stage,the differences was statistically significant(P < 0.05).total cholesterol,CKD2 group and CKD3 group of low density lipoprotein,systolic blood pressure,diastolic blood pressure is higher than that of CKD1 group(P<0.05),but in CKD2 group and CKD3 group without now the difference(P>0.05);triglyceride,high density lipoprotein,insulin resistance index,no significant differences in HbA1 c,aspartate aminotransferase and alanine aminotransferase in three groups(P>0.05);the prevalence rate of HUA in UAER1 group and UAER2 group And UAER3 group showed an increasing trend,the difference was statistically significant(P<0.01);The prevalence of HUA in CKD1 group,CKD2 group and CKD3 group showed an increasing trend,the difference was statistically significant(P<0.01).Logistic regression analysis showed that uric acid,duration of disease,BMI,serum creatinine,eGFR,family history,age and systolic blood pressure were correlated with diabetic nephropathy(P<0.01),which were the risk factors of diabetic nephropathy.Conclusion: Uric acid is closely related to type 2 diabetic nephropathy,and hyperuricemia can aggravate the injury of glomerular,which may be involved in the occurrence and development of T2 DKD.In the clinical work,the prevention of the above risk factors should be strengthened to protect the renal function of diabetic nephropathy,delay the progress of the disease and improve the quality of life of the patients.