| Research objectiveTo study the correlation and clinical significance of serum uric acid level(SUA)with type2 diabetes early nephropathy(T2DN),analyze the effect of peripheral SUA on the occurrence and development of early T2 DN,and further explore the diagnostic application of peripheral SUA in early T2 DN value.Research Methods1.Data collection: A total of 195 cases of early T2 DN patients and 106 cases of type 2diabetes(T2DM)were selected from November 2015 to December 2017 in Shaanxi Provincial People's Hospital.Collect general clinical data for all patients: gender,age,duration of diabetes,family history of diabetes,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI);determination of biochemical markers: glycated hemoglobin(HbA1c),SUA Level,BUN,Scr,Cys C,RBP,UACR,glomerular filtration rate(eGFR),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),homocysteine(HCY).2.Experimental design:(1)Analyze the prevalence of hyperuricemia(HUA)in all enrolled patients and patients with early T2DN;(2)Comparative analysis of general clinical data and biochemical indicators in patients with early T2 DN and T2 DM alone;(3)According to peripheral SUA levels,patients in early T2 DN group were divided into elevated serum uric acid group(HUA,n=115)and normal uric acid group(NUA,n=91).The distribution ofclinical parameters in HUA group and NUA group was analyzed.(4)The subgroups of SUA levels in early T2 DN patients were grouped and the distribution of renal injury indicators(UACR,eGFR)was analyzed;(5)In the early T2 DN group,explore the peripheral SUA levels and clinical The correlation of the indicators;(6)Regression analysis was used to determine whether peripheral SUA was an independent risk factor for early T2 DN.The ROC curve was used to determine the critical value of peripheral SUA for early diagnosis of T2 DN,and the value of peripheral SUA for the diagnosis of early T2 DN was evaluated.Research result1.Among the 301 patients selected(early T2 DN and T2 DM alone),the prevalence of HUA was 40.86%(n=123),and the prevalence of HUA in the early T2 DN group was 56.92%(n=111)?2.Compared with the T2 DM group,the patients with early T2 DN had a longer duration of diabetes and had higher blood pressure levels,BMI,HbA1 c,SUA(412.99±57.16 VS330.94±69.94),BUN,Scr,Cys C,RBP,UACR [80.00(58.85,99.00)VS 19.00(13.95,23.84)],TG,TC,HCY,but with lower HDL-C,eGFR(94.86±8.36 VS 109.41±7.89),the difference was statistically significant(P<0.001).3.In the early T2 DN group,the ratio of family history of diabetes in the HUA group was higher than that in the NUA group,and there was a longer duration of diabetes,higher BMI,DBP,HbA1 c,BUN,Scr,Cys C,RBP,UACR [90.00(78.00,111.85)VS 68.50(51.45,87.00)],TG,TC,HCY,but with lower HDL-C,eGFR(92.39±8.12 VS 97.81±7.85),the differences were statistically significant(P<0.05).4.Patients in the early T2 DN group were divided into four subgroups of SUA levels(387umol/L,420umol/L,440umol/L).The results showed that in the early T2 DN group,UACR gradually increased and eGFR decreased with the increase of peripheral SUA levels,and the differences were statistically significant(P<0.001).5.In the early T2 DN group,Spearman correlation analysis of peripheral SUA levels and major clinical indicators showed: peripheral SUA levels and BMI,SBP,DBP,HbA1 c,BUN(r=0.311**),Scr(r=0.245**),Cys C(r=0.310**),RBP(r=0.172*),UACR(r=0.423**),TG,TC,and HCY were positively correlated;peripheral SUA levels were negatively correlated with eGFR(r=-0.307**)and HDL-C,and the correlation was statistically significant(P < 0.05).6.Risk factors for early T2 DN analysis: The regression model included gender,age,duration of diabetes,family history of diabetes,BMI,SBP,DBP,HbA1 c,SUA,UACR,eGFR,TG,TC.Logistic regression analysis showed that BMI,HbA1 c,UACR,eGFR,and SUA were independent risk factors for early T2 DN,and the risk of peripheral T2 DN for early T2 DN was2.729(95% CI: 1.771,4.204,p<O.001).7.The ROC curve analysis of peripheral T2 DN predicting early T2 DN in male and postmenopausal women showed that the area under the curve of peripheral T2 DN in the diagnosis of early T2 DN was 0.838(95% CI: 0.789-0.886,P<0.001),when the best cut off ofperipheral SUA was taken With a value of 382.5 ?mol/L,the sensitivity and specificity for diagnosis of early T2 DN were 78.5% and 85.8%,respectively.Research conclusion1.The peripheral SUA level was significantly associated with early T2 DN and was an independent risk factor for early T2DN;2.Peripheral SUA participated in the occurrence and development of early T2DN;3.The peripheral SUA level has a certain application value in the diagnosis of early T2 DN,and can be used as one of the clinical indicators to assist in the diagnosis of early T2 DN. |
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