Correlation Analysis Between Lp(a),apoA-Ⅰ,apoB And Type 2 Diabetic Nephropathy

Objective : In this study,the correlation between Lp(a),apo A-Ⅰ,apo B,apo B/apo A-Ⅰ and type 2 diabetic nephropathy was investigated by comparing the levels of plasma Lp(a),apo A-Ⅰ,and apo B in patients with type 2 diabetic nephropathy.Methods : Four hundred and twenty-eight patients with type 2diabetes mellitus with or without diabetic nephropathy who were hospitalized in the Endocrinology Department of our hospital from September 2019 to September 2021 were selected.Patients with uncomplicated diabetic nephropathy were divided into control group G0 and patients with complicated diabetic nephropathy were divided into groups G1,G2,G3 and G4 according to guidelines for quality of life in kidney disease(KDOQI)developed by the American Kidney Disease Foundation in 2012 and the Clinical Guidelines for the Prevention and Treatment of Diabetic Nephropathy in China developed by the Chinese Medical Association’s Diabetic Branch in 2019.Collect the general data and laboratory test data of the research subjects,calculate the BMI,e GFR,apo B/apo A-Ⅰ equivalents,and compare the plasma Lp(a),apo A-Ⅰ,apo B,apo B/apo A-Ⅰ levels between different groups.The correlation between Lp(a),apo A-Ⅰ,apo B,apo B/apo A-Ⅰ and diabetic nephropathy was analyzed.Results: 1.The levels of UA,CYSC,Lp(a),apo B/apo A-Ⅰ,NLR,and NMP in different groups of patients with type 2 diabetic nephropathy gradually increased,while the levels of apo A-Ⅰ and FT3 gradually decreased.Statistically significant(P ≤ 0.001).2.The results of correlation analysis showed that the more severe the severity of diabetic nephropathy,the higher the levels of Lp(a),apo B and apo B/apo A-Ⅰ were,and the lower the level of apo A-Ⅰ was.Lp(a),apo B,apo B/apo A-Ⅰ were positively correlated with UACR,Scr,UA,CYSC and BUN,but negatively correlated with e GFR.apo A-Ⅰ was negatively correlated with UACR,Scr,UA,CYSC,and BUN,but positively correlated with e GFR.3.Partial correlation analysis after adjusting for confounding factors(sex,age,BMI,course of diabetes,course of hypertension,traditional blood lipids,thyroid hormone),Lp(a)was still positively correlated with Scr,UACR,UA,and CYSC,and negatively correlated with e GFR.aop A-Ⅰ was still negatively correlated with Scr,UACR,UA,and CYSC,and positively correlated with e GFR.apo B and apo B/apo A-Ⅰ were still positively correlated with Scr,UACR and CYSC.apo B/apo A-Ⅰ still negatively correlated with e GFR.4.G0 group was divided into T2 DM group,G1-G4 group was divided into DKD group,Lp(a),aop A-Ⅰ,apo B/apo A-Ⅰ were significantly different between the two groups(P<0.05),while there was no significant difference in apo B between the two groups(P>0.05).Draw the ROC curve of Lp(a),apo A-Ⅰ,apo B,apo B/apo A-Ⅰ for predicting type 2 diabetic nephropathy,the area under the curve is 0.737(95%CI: 0.690-0.785,P<0.001),0.710(95%CI:0.660-0.760,P<0.001),0.708(95%CI: 0.643-0.745,P<0.001),0.730(95%CI: 0.683-0.778,P<0.001).According to the Youden index,the optimal critical values of Lp(a),aop A-Ⅰ,apo B and apo B/apo A-Ⅰ were calculated as 0.460,0.346,0.404 and 0.437.That is when Lp(a)>38.460,aop A-Ⅰ>1.085,apo B>0.935,and apo B/apo A-Ⅰ>0.798,it indicates that the probability of diabetic nephropathy in type 2 diabetic patients is significantly increased.Conclusions:1.Lp(a),apo A-Ⅰ,apo B/apo A-Ⅰ are related to diabetic nephropathy in patients with type 2 diabetes,and the relationship between apo B and type 2 diabetic nephropathy needs to be further clarified.2.When Lp(a)>38.460,aop A-Ⅰ>1.085,and apo B/apo A-Ⅰ>0.798,the probability of diabetic nephropathy in patients with type 2 diabetes increased significantly.