| Background and Objective:In patients with type 2 diabetes mellitus(T2DM),diabetic kidney disease(DKD)is a common microvascular complication,and carotid atherosclerosis is a common macrovascular complication,which is closely related.Previous lack of good serological markers predicted the risk of carotid atherosclerosis in DKD.This study aims to discuss the association of B-type natriuretic peptide(BNP)and carotid atherosclerosis in patients with DKD.And to evaluate the value of BNP as a serological marker for predicting carotid atherosclerosis.MethodA total of 252 patients with type 2 diabetic nephropathy who were hospitalized in the Department of Endocrinology and Metabolism of the Second Affiliated Hospital of Nanchang University from December 2018 to June 2022 and were divided into carotid atherosclerosis group(C-IMT 1.0mm,n=114)and C-14 normal group(C-IMT <1.0mm,n=138).General data and biochemical parameters were collected in both groups: gender,age,duration of diabetes,body mass index(BMI),SBP,systolic BP),diastolic BP(DBP),fasting blood glucose(FPG),fasting C peptide(FCP),and 2h after meal C peptide(2h-CP),glycosylated hemoglobin(Hb A 1 c),triglycerides(TG),cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),serum albumin(Alb),creatinine(Scr),blood uric acid(UA),estimated glomerular filtration rate(e GFR),urinary microalbumin / creatinine ratio(UACR),C reactive protein(CRP),folate,vitamin B12 and BNP;risk stratification of DKD progression was performed together with e GFR and UACR grade.1.Analyze the differences in general data and biochemical indicators of the two groups.2,linear regression was used to analyze the correlation of BNP levels and C-IMT values.3,using multivariate Logistic regression to analyze the effect of BNP levels on carotid atherosclerosis.4,the predictive value of BNP in DKD patients by ROC curve.Results:1.In DKD patients,men in the carotid atherosclerosis group had a higher proportion of males,higher BNP,TC and LDL,and a statistically significant difference(all P <0.05).2.Linear regression analysis with C-IMT values as the dependent variable showed that BNP level,risk stratification for DKD progressionand and age were positively associated with C-IMT values(P <0.05),C-IMT values were higher in females than in males(P <0.05)..3.Multivariate Logistic regression analysis with the occurrence of carotid atherosclerosis as the dependent variable showed that BNP level,risk of DKD progression,increased TC level and female gender were independent risk factors for carotid atherosclerosis in DKD(OR values were 1.007,1.513,1.929 and 2.437,respectively,P <0.05).4.By value of BNP by the ROC curve to predict the value of carotid atherosclerosis in DKD,the area under the ROC curve(AUC)was 0.684(P <0.001),and the optimal cut-off for BNP was 90.21pg/mol when the Youden index reached the maximum value of 0.282.The corresponding sensitivity and specificity were 64.9%and 63.3%,respectively.Conclusion:In patients with DKD,BNP levels are significantly associated with carotid atherosclerosis,and elevated BNP levels can increase the risk of carotid atherosclerosis,and BNP levels may have good predictive value for the development of carotid atherosclerosis. |
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