Study On The Correlation Between Homocysteine,Uric Acid And Type 2 Diabetic Nephropathy

Purpose:To study the correlation between homocysteine and uric acid and type 2 diabetic nephropathy,and to explore the application value of both in the diagnosis and treatment of diabetic nephropathy,in order to provide a new perspective for the diagnosis of diabetic nephropathy.Research methods:The medical history,clinical tests and other data of 164 patients with T2 DM were collected.These patients were admitted to the hospital from January 2021 to August 2022.Among them,42 patients with simple T2 DM were included in group D,and 122 patients with T2 DM combined with DKD.According to the urinary albumin/creatinine Ratio grouping test results,group A(UACR < 30 mg/g)and group B(30 mg/g UACR or less < 300 mg/g),group C(UACR acuity 300 mg/g).The patients’ general data,such as age,systolic blood pressure,course of disease,and complicated underlying diseases,as well as clinical biochemical data,such as uric acid,homocysteine and fasting blood glucose,were collected.SPSS27 statistical software was used to analyze the data.Variance analysis or Kruskal-Wallis rank sum test was used to compare the differences between groups.Postmortem tests(multiple comparisons)of multigroup analyses were corrected with Bonferroni methods.Spearman correlation analysis was used to analyze the correlation between UACR and serum creatinine.The risk factors of DKD were analyzed by multiple logistic regression.Receiver operating curve(ROC curve)was plotted by Medcalc software to analyze the diagnostic value of Hcy and other indicators for DKD.Result:1.There were statistically significant differences in diabetes course and systolic blood pressure between groups(P < 0.05),while there were no statistically significant differences in gender,age,body mass index,diastolic blood pressure and underlying diseases of coronary heart disease and cerebral infarction between groups(P >0.05).The course of disease in group D was 60(10,108)months,and the difference between group D and Group B and C was statistically significant(P < 0.05).There was statistical significance in systolic blood pressure between the two groups(P <0.05).2.There were statistically significant differences in serum creatinine,urea nitrogen,uric acid,24-hour urinary protein and e GFR among groups(P < 0.05).There were statistically significant differences in uric acid levels among AC,BC,DC and BD groups(P < 0.05).Scr in group C was significantly higher than that in group A,B and D,the difference was statistically significant(P < 0.05);e GFR in group C was significantly lower than that in groups A,B and D,the difference was statistically significant(P < 0.05);urea nitrogen in group C was higher than that in groups B and D,the difference was statistically significant(P < 0.05).24-hour urine protein test results showed that the difference between the two groups was not statistically significant(P=0.447),and any pairings of the remaining AC,AD,BC,BD and CD were statistically significant(P < 0.05).3.There was no significant difference in HBA1 c and triglyceride among the four groups(P > 0.05).There were significant differences in cholesterol,fasting blood glucose and low density lipoprotein among the four groups(P < 0.05).There was significant difference in fasting blood glucose between the two BD groups(P=0.048).Cholesterol in group C was higher than that in groups A,B and D,and the differences were statistically significant(P < 0.05).The difference of low density lipoprotein between the two BC groups was statistically significant(P=0.009).The HCY of group C was higher than that of group A,B and D,and the difference was statistically significant(P < 0.05),and the difference between group B and group D was statistically significant(P < 0.05).4.UACR was positively correlated with uric acid,homocysteine,systolic blood pressure,low density lipoprotein,creatinine,triglyceride,urea nitrogen,24-hour urinary protein,cholesterol and disease course(P < 0.05),and negatively correlated with e GFR(P < 0.05).There was no correlation with sex,age,diastolic blood pressure,body mass index,glycosylated hemoglobin and fasting blood glucose(P > 0.05).5.Increased disease duration(OR1.008,95%CI1.004-1.012,P < 0.001),fasting blood glucose(OR1.173,95%CI1.054-1.305,P=0.004),and HCY(OR1.159,95%CI1.059-1.291,P=0.001)and increased uric acid(OR1.005,95%CI1.005-1.009,P=0.007)were risk factors for DKD.6.ROC curve analysis showed that the area under the curve(AUC)of homocysteine diagnosis of DKD was 0.716,the sensitivity was 79.7%,and the specificity was 60.4%.The AUC,sensitivity and specificity of uric acid for DKD were0.653,40.4% and 86.4%.When uric acid combined with homocysteine diagnosed DKD,the AUC was 0.734,the sensitivity was 58.3%,and the specificity was 83.1%.Conclusion:1.UACR was positively correlated with uric acid,homocysteine,systolic blood pressure,low-density lipoprotein,creatinine,triglyceride,blood urea nitrogen,24-hour urinary protein,cholesterol and disease course in patients with diabetes mellitus type 2.2.Prolonged course of disease,elevated fasting blood glucose,elevated uric acid and elevated homocysteine are risk factors for DKD.3.Elevated homocysteine and uric acid are valuable for the diagnosis of type 2diabetic nephropathy.