| Objective:To investigate the correlation between serum soluble CD36(sCD36)and diabetic renal disease(DKD)and left ventricular hypertrophy.Methods:Patients admitted to the Department of Nephrology and Endocrinology of the Second Affiliated Hospital of Kunming Medical University between June 2020 and December 2020 who were diagnosed with type 2 diabetes and DKD were enrolled.The patients were divided into group A:patients with type 2 diabetes;Group B:Diabetic kidney disease patients.Serum sCD36 concentration was determined by enzyme-linked immunosorbent assay(ELISA).Demographic data of patients were collected,including age,gender,height,weight,systolic blood pressure,diastolic blood pressure,smoking history,drinking history,taking lipid-lowering drugs,and complications(hypertension,cardiovascular disease,etc.);Laboratory data:Including white blood cell count,neutrophil count,platelet,hemoglobin,albumin,prealbumin,serum creatinine,blood urea nitrogen,uric acid,total cholesterol,triglycerides,high-density lipoprotein cholesterol,low density lipoprotein cholesterol,lipoprotein,apolipoprotein Al,apolipoprotein B,fasting blood sugar and urine alpha 1-microglobulin,urine trace albumin,urine trace albumin/urinary creatinine,urinary N-acetyl-β-D-glucosidase and other indicators;Echocardiography:including ejection fraction(LEVF),left ventricular end-diastolic diameter(LVDD),left ventricular posterior wall thickness(LVPWT),ventricular septal wall thickness(IVST),left atrial diameter(LAD).Clinical data and serum levels of SCD36 were compared between the two groups,Spearman correlation analysis was performed between serum SCD36 and clinical influencing factors,multivariate logistics regression was used to analyze the independent risk factors for diabetic kidney disease,and receiver operating characteristic curve(ROC)was drawn.Curve area(AUC)was used to evaluate the predictive value of independent risk factors for diabetic renal disease.Furthermore,univariate and multivariate logistic regression analysis was used to identify the independent risk factors for DKD patients with left ventricular hypertrophy.Results:1.A total of 133 patients were included in this study,with an average age of(58.8±13.5)years,72 males(54.14%)and 61 females(45.86%),including 71 patients in Group A with an average age of(57.0±13.1)years,and 62 patients in Group B with an average age of(61.0±13.8)years.Comparison of demographic data between the two groups:SBP in group B was higher than that in group A(P=0.003),and other demographic data showed no statistically significant difference.Laboratory indicators:The neutrophil count,urinary N-acetyl-β-D-glucosidase,urinary al-microglobulin,urea nitrogen,serum creatinine,uric acid,urinary microalbumin/urinary creatinine,and serum sCD36 in group B were significantly higher than those in group A,and the differences were statistically significant(P<0.05),the glomerular filtration rate(eGFR),hemoglobin and albumin in group B were significantly lower than those in group A,the difference was statistically significant(P<0.05),while there was no significant difference in other laboratory indicators between the two groups(P<0.05).2.Spearman correlation analysis showed that serum sCD36 was positively correlated with systolic blood pressure,urinary al-microglobulin,,urea nitrogen,serum creatinine,uric acid,urinary microalbumin/urinary creatinine and renal disease(P<0.05),was negatively correlated with eGFR(P<0.001),and had no correlation with triglycerides,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,lipoproteinA,apolipoproteinA1,and apolipoprotein B.3.Univariate and multivariate logistic regression analysis showed that serum sCD36(P=0.009,OR=4.591),history of hypertension(P=0.012,OR=3.625),urinary α1-microglobulin(P=0.014,OR=1.373)and urea nitrogen(P=0.020,OR=1.490)were independent risk factors for diabetic renal disease in patients with type 2 diabetes.4.The results of ROC curve showed that serum sCD36,urea nitrogen andα1-microglobulin had good predictive value for the occurrence of DKD,and the areas under the ROC curve were 0.723,0.715 and 0.710,respectively,among which serum sCD36 had the highest predictive value.The multivariate model combined with serum sCD3 6,urea nitrogen,urinary α1-microglobulin and hypertension had the highest predictive power for DKD(AUC=0.838,P<0.001).5.Compared with the echocardiography of group A and group B,LVDD,LVPWT,TVST,LAD and LVMI of group B were significantly increased(P<0.05),and there was no significant difference between the LEVF groups(P<0.05),the proportion of patients with left ventricular hypertrophy in group B was significantly higher than that in group A(P=0.003).Spearman correlation analysis showed that serum sCD36 was positively correlated with LVPWT,IVST,LAD,LVMI and the presence of left ventricular hypertrophy(all P<0.05).For group B,univariate and multivariate logistic regression analysis showed that:Age(P=0.017,OR=1.078),systolic blood pressure(P=0.002,OR=1.079),serum sCD36(P=0.028,OR=6.426)were independent risk factors for left ventricular hypertrophy in patients with DKD.Conclusions:1.The level of serum sCD36 in patients with DKD was significantly higher than that in patients with type 2 diabetes2.Serum sCD36 levels were positively correlated with serum creatinine,urea nitrogen,uric acid,LVPWT,IVST,LAD and LVMI,but not with triglycerides,high density lipoprotein cholesterol or low density lipoprotein cholesterol.3.Serum sCD36 may be an independent risk factor for the occurrence of DKD in patients with type 2 diabetes,and has important predictive value for DKD,while the combination of sCD36,urea nitrogen,urinary α1-microglobulin and multivariate hypertension model has the highest predictive efficiency for DKD.4.The incidence of left ventricular hypertrophy is high in patients with DKD,and serum sCD36 is an independent risk factor for the complication of left ventricular hypertrophy in this population... |
