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Objectives:To investigate the relationship between visceral adipose index and glomerular filtration rate in patients with type 2 diabetes mellitus.Methods:A total of 1 036 patients with type 2 diabetes mellitus who received treatment in The Second Affiliated Hospital of Xi'an Jiaotong University from May 2017 to May 2018 were included in this study. The visceral adipose index was detected using a bioresistance assay. These patients were divided into four groups using the quartile method: Visceral adipose index < 8.10 (q1 group, n = 246), 9.60 > visceral adipose index ≥ 8.10 (q2 group, n = 64), 11.10 > visceral adipose index ≥ 9.60 (q3 group, n = 423), visceral adipose index ≥ 11.10 (q4 group, n = 233). One-way analysis of variance was performed to compare the differences among groups. Partial correlation and multiple regression were used to analyze the correlation between body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, body fat content, visceral adipose index, and urinary microalbumin and glomerular filtration rate. Results:With the increase in the visceral adipose index, the glomerular filtration rate gradually decreased. The glomerular filtration rate in the q1, q2, q3, q4 groups was (112.19 ± 31.74) mL·min -1·1.73 m -2, (106.14 ± 28.26) mL·min -1·1.73 m -2, (104.73 ± 23.63) mL·min -1·1.73 m -2, (103.40 ± 27.51) mL·min -1·1.73 m -2, respectively. In the female group, with the increase in visceral adipose index, the glomerular filtration rate decreased gradually. After controlling for age, sex, diabetes, and hypertension, the visceral adipose index was significantly correlated with the glomerular filtration rate ( r = -0.10, P < 0.001). Multiple regression analysis showed that visceral adipose index and waist-to-height ratio were closely related to glomerular filtration rate ( F = 6.00, P < 0.001). Conclusion:With the increase of visceral adipose index, body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, body fat content, and urinary microalbumin increased gradually. When the visceral adipose index is greater than 9.60, the glomerular filtration rate is significantly decreased. Therefore, it is suggested to adopt various methods to evaluate obesity in clinical work, and visceral fat index should be paid more attention, especially when the visceral fat index is greater than 9.60.
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Objective:To investigate the correlation between early renal impairment markers in urine and elevated serum homocysteine.Methods:Clinical data of serum homocysteine (Hcy) and early renal injury markers in urine of the health examination population from the Physical Examination Center of Peking University Third Hospital from January 2019 to May 2020 were retrospectively analyzed (1133 cases). The previous medical history, age, sex, blood pressure, body mass index (BMI) of the subjects were collected. Early urine kidney injury markers, including urine microalbumin (U-mALB), urinary N-acetyl-β-D-glucosaminidase (NAG), urinary albumin to creatinine ratio (UACR), and serum renal function, liver function, blood lipid, myocardial enzyme and glycosylated hemoglobin (HbA 1C), etc. were also collected. Those with incomplete previous history, general information, biochemical indexes and decreased estimated glomerular filtration rate (eGFR) were excluded, and 969 cases were included. The included subjects were divided into the normal group (?15 μmol/L) and the elevated group (≥15 μmol/L) according to Hcy levels, the indexes with significant difference between the two groups were included as independent variables, and the multivariate logistic regression was used to explore the influence factors of Hcy elevation. Results:The male ratio, the incidence of increased U-mALB, NAG and UACR were significantly higher in the elevated group than those in the normal Hcy group (93.4% vs 50.6%, 16.4% vs 8.0%, 23.0% vs 14.0%, 13.9% vs 7.9%) (all P<0.05). Systolic blood pressure, diastolic blood pressure, serum uric acid, calcium, alanine aminotransferase (ALT) and lactate dehydrogenase in the elevated group were higher than those in the normal group [(127.5±15.4) vs (121.9±16.2) mmHg (1 mmHg=0.133 kPa), (78.6±9.3) vs (76.0±11.0) mmHg, (385.9±86.0) vs (335.7±88.2) μmol/L, (2.392±0.086) vs (2.366±0.092) mmol/L, (27.8±21.0) vs (23.8±20.2) U/L, (198.3±28.4) vs (192.2±31.2) U/L] (all P<0.05), while high density lipoprotein cholesterol (HDL-C), serum phosphorus were lower than those in the normal group [(1.21±0.25) vs (1.31±0.30) mmol/L, (1.107±0.154) vs (1.158±0.159) mmol/L] (all P<0.05). The increased systolic blood pressure, male, uric acid, U-mALB, NAG were independent correlative factors of Hcy elevation. Conclusion:The increase of Hcy is independently correlated with urine U-mALB and NAG, which suggests that the level of Hcy should be detected as soon as possible in patients with elevated early renal injury markers.
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@#AIM: To explore the correlation between urinary microalbumin creatinine ratio and diabetic retinopathy(DR)in type 2 diabetic patients in Hefei area. <p>METHODS: A retrospective case analysis. 281 patients with type 2 diabetes mellitus(T2DM)hospitalized in Hefei Second People's Hospital from November 2018 to September 2019 were conducted in this study. According to the digital fundus photography, the patients were divided into diabetic retinopathy group(DR group)and non-diabetic retinopathy group(NDR group). The patients' gender, age, course of diabetes, history of hypertension, body mass index(BMI), blood urea nitrogen(BNU), urinary microalbumin creatinine ratio(UACR),fasting blood glucose, HbA1c, total bilirubin(TB), total cholesterol(TC), triglyceride(TG)were collected and risk factors of DR were analyzed.<p>RESULTS: A total of 281 cases, 169(60.1%)were in the NDR group and 112(39.9%)in the DR group. Logistic regression analysis and ROC curve analysis showed that the risk factors related to DR were UACR(β=0.036,<i> OR</i>=1.037, 95% <i>CI</i>:<i> </i>1.019-1.056, <i>P</i><0.001), the best critical value was 10.15mg/g·Cr(AUC=0.717, <i>P</i><0.001); the course of diabetes(β=0.061, <i>OR</i>=1.063, 95% <i>CI</i>: 1.008-1.120, <i>P</i>=0.023), the best critical value was 10.5a(AUC=0.666, <i>P</i><0.001).<p>CONCLUSION: UACR and the course of diabetes are independent risk factors for DR in some of the patients with type 2 diabetes in Hefei.
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Objective To investigate the value of serum amyloid A (SAA) and retinol binding protein (RBP) in diagnosis of early type 2 diabetic kidney disease (DKD).Methods A total of 182 type 2 diabetic patients hospitalized in department of Endocrinology and Nephrology of Lianyungang Second People's Hospital from January to December 2017 were randomly collected as subjects.According to urinary albumincreatinine ratio (UACR),all subjects were divided into three groups of normal albuminuria group (NA,60 cases),microalbuminuria group (MA,63 cases) and clinical proteinuria (CP,59 cases).In the same period,60 healthy persons were selected as normal control (NC).The levels of serum SAA and RBP were detected by automatic biochemical analyzer.Receiver operating curve (ROC) was used to analysis the diagnostic efficiency of DKD and the risk factors of DKD were further estimated.Results The levels of SAA were (6.88±2.82) and (37.21±20.58) mg/L in control group and case group.And levels of serum SAA in the NA group,MA group and CP group were (16.33±5.98),(40.97± 15.62),(54.43±22.91) mg/L respectively.The levels of RBP were (37.56± 10.51) and (69.26±21.23) mg/L in control group and case group.And levels of RBP in the NA group,MA group and CP group were (52.66 ± 14.31),(69.66 ± ± 15.52),(85.70± 19.51) mg/L respectively.The concentrations of serum SAA and RBP in type 2 diabetic patients were significantly higher than those normal controls (t =10.36,P＜0.05;t =11.11,P＜0.05) and increased with DKD progression (F =83.6,P＜ 0.05;F =59.2,P＜ 0.05).Diagnostic sensitivity of serumSAA,RBP in DKD was 81.8％ and 84.1％ respectively.Diagnostic sensitivity of combined detection was 90.9％.Regression analysis showed that SAA,RBP and UACR were independent risk factors for DKD (OR (95％ CI) =1.391 (1.068-1.812),1.212 (1.085-1.353),1.148 (1.038-1.270);all P ＜0.05).Conclusion Both of serum SAA and RBP were significantly elevated in diabetic patients with renal injury so that they had great value in early diagnosis of DKD.
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Objective To investigate the value of plasma neutrophil gelatinase-associated lipocalin (NGAL),cystatin C (Cys C) and the ratio of urinary N-acetyl-beta-D-glucosaminidase to creatinine (NAG/Crea) combined determination in the diagnosis of early diabetic nephropathy.Methods Collected 67 cases of patients with type 2 diabetes hospitalized in the First Affiliated Hospital of Kunming Medical University from December 2016 to February 2017.According to the value of UALB/Crea was divided into two groups:Diabetic urinary microalbumin normal group (UALB/Crea＜30 mg/gCrea) had 35 patients and early diabetic nephropathy group (namely the trace albuminuria group,UALB/Crea 30 ～ 300 mg/gCrea) had 32 patients.Other selected 20 normal volunteers as control group,compared with a medical group to gather all the staff of the clinical data,using automatic biochemical analyzer detected the plasma NGAL,Cys C and urine NAG/Crea,and adopted the receiver-operating characteristic (ROC) curve of the detection index was analyzed.Results ①Plasma NGAL,Cys C and urinary NAG/Crea of diabetic nephropathy patients was significantly higher than those of healthy control group (Z=-5.740 ～-5.386,P＜0.05).②The areaunder receiver operating characteristic (ROC) curve of plasma NGAL,Cys C and urine NAG/Crea were 0.858,0.911 and 0.714.Conclusion Plasma NGAL,Cys C and urinary NAG/Crea combined determination have a higher value for early diagnosis of diabetic nephropathy.
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Objective To investigate the changes of urinary microalbumin(mALB)and type B urinary na-triuretic peptide(BNP)in the patients with diabetic nephropathy(DN)complicating heart failure and their in-fluence on recent prognosis.Methods A total of 73 patients with diabetes mellitus(DN)complicating heart failure from January 2014 to December 2016 were selected as the observation group and 73 persons undergoing healthy physical examination were selected as the control group.The urinary mALB and BNP levels in the two groups and the patients with different heart function grades were analyzed.The receiver operating characteris-tic(ROC)curve and survival curve were drawn for analyzing their diagnostic value and influence on progno-sis.Results The levels of urinary mALB and BNP levels in the observation group were significantly higher than those in the control group,the difference was statistically significant(P< 0.05).In the observation group,the poorer the heart function,the more obvious the urinary mALB and BNP abnormality,the difference was statistically significant(P<0.05).When the critical value of urinary mALB for diagnosing DN complica-ting heart failure was 18.56 ng/L,the area under the curve(AUC),95% CI,sensitivity and specificity were 0.983,0.964 -0.999,0.986 and 0.900 respectively,the difference was statistically significant(P< 0.05);
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Objective To analyze the risk factors of early renal damage in children with Henoch Schonlein purpura(HSP).Methods The clinical data of 196 children with HSP admitted to our hospital from April 2012 to January 2016 were analyzed retrospectively.They were divided into the renal damage group and non-renal damage group within 90 d after confirmed diagnosis.The related clinical data such as serum immunoglobulin and urinary microalbumin were compared between the two groups,and the risk factors of early renal damage in children with HSP were screened.Results There were significant differences between the two groups on age,joint symptoms,recurrent purpura,persistent rash,gastrointestinal bleeding and abdominal pain(with χ2 or t of 11.345,16.223,11.275,43.211,12.592,17.771,P<0.05).The white blood cell count,platelet count,immunoglobulin A(IgA) level and urinary albumin level also showed significant differences between the two groups(t=33.750,60.442,9.451,8.458,P<0.05).The multivariate regression analysis showed that the independent risk factors for early renal damage in children with HSP included age(OR=2.703),recurrent purpura(OR=2.721),persistent skin rash(OR=1.782),gastrointestinal bleeding(OR=11.472),abdominal pain(OR=2.046),IgA level(OR=1.221) and urine microalbumin(OR=3.214).Conclusion Age,recurrent purpura,persistent skin rash,gastrointestinal bleeding,abdominal pain,IgA level and urine microalbumin are closely related to early renal damage in children with HSP.
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Objective To analyze the relationship between the serum CysC,lipoprotein(a) [Lp(a)] and the urinary microalbumin/creatinine ratio in elderly type 2 dibetic (T2CM) patients.Methods A total of 102 elderly patients with T2CM who were treated in our hospital from December 2014 to December 2015 were selected.The patients were divided into diabetic nephropathy(DN) group(mALB≥20 μg/min,48 cases)and non-diabetic nephropathy(NDN) group (mALB<20 μg/min,54 cases) according the levels of urinary mALB,while 30 cases of healthy controls were selected from physical examination center.The biochemical indexes,CysC,Lp(a) and UACR were detected among all cases.The correlation between indexes and UACR was analyzed by Pearson correlation analysis,risk factors for UACR among DN patients were analyzed by Logistic regression analysis.Results There were significant differences in levels of low density lipoprotein cholesterol(LDL-C),Lp(a),urea,creatinine,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),Cysc,and UACR among these groups (P<0.05).No correlation between CysC、Lp(a) and UACR was found in normal-control group and non-diabetic nephropathy group.In diabetic nephropathy group,there was a positive correlation between CysC,Lp(a) and UACR(r=0.658,P<0.01;r=0.525,P<0.05).The Logistic regression analysis showed that diabetes duration,CysC,Lp(a) were independent risk factors for UACR(P<0.05).Conclusion In patients with diabetic nephropathy,CysC,Lp(a) are positively correlated with UACR,and CysC is a sensitive index that reflect early renal damage in T2DM patients.Lp(a) level is one of the independent risk factors for UACR,which can reveal the kidney damage in DN patients.
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Objective To explore the clinical value of joint detection of urine light chains ,urine microalbumin and urine α1-mi-croglobulin in early diabetic kidney injury .Methods 218 cases type 2 diabetes mellitus(T2DM ) were selected as the observational group and 62 cases undergoing healthy physical examination as the control group .The rate scattering turbidimetry method was a-dopted to detect urinary κlight chains ,urinary λlight chains ,urinary micro-albumin(mALB) ,α1-microglobulin(α1-MG) in the two groups .Then the test results were performed the comparative analysis .Results The positive rate of urine κ light chains ,urine λlight chains ,mALB and α1-MG in the observational group were significantly higher than those in the control group ,the difference was statistically significant(P<0 .01);theκ/λvalue had no statistical difference between the observation group and control group (P>0 .05) .The receiver-operating characteristic curve analysis showed that the area under curve (AUC) of urineκlight chains ,u-rineλlight chains ,mALB and α1-MG ,and 95% CI were 0 .763 ,0 .541 ,0 .854 ,0 .807 and 0 .708 -0 .817 ,0 .464-0 .691 ,0 .811-0 .897 and 0 .758-0 .856 respectively ,AUC and 95% CI of joint detection of 4 urine indicators were 0 .919 and 0 .886-0 .951 ,the difference was statistically significant(P<0 .01) .Conclusion The combined detection of urine κ light chains ,urineλ light chains , mALB and α1-MG has an important clinical value for predicting early diabetic kidney injury .
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Objective To analyze the variation tendency of correlative test indexes in the patients with type 2 diabetic mellitus (T2DM) and diabetic nephropathy (DN) .Methods The urinary microalbumin (M‐Alb) ,blood glucose and renal function were de‐termined in 167 cases of T2DM .Then the cases were divided into the simple DM group ,early DN group and clinical DN group ac‐cording to the excretion rates of urinary M‐Alb .The determined results were compared among 3 group and analyzed .Results The age in the simple DM group was smaller than that in the early DN group and clinical DN group (P<0 .05) .The positive rates of u‐rinary M‐Alb and urinary protein were highest in the clinical DN group ,the differences among 3 groups had statistical significance (P<0 .05) .The difference of blood glucose indexes had no statistical difference between the simple DM group and early DN group , the clinical DN group was apparently higher than that in the simple DM group and early DN group (P<0 .05) .The levels of urea (Urea) and creatinine(Cr) in the simple DM group were significantly lower than those in the early DN group and clinical DN group ,the differences among 3 groups had statistical significance (P<0 .01) .Conclusion The severe the DN ,the higher the urina‐ry M‐Alb ,blood glucose and renal function indicators ,the higher the positive rates of urinary protein and urinary glucose ,the more significant the tendency of renal function damage .
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Objective To observe the changes of ambulatory arterial stiffness index (AASI) and target organ damage (TODs) after antihypertensive treatment in hypertensive patients .Methods A total of 300 cases of newly diagnosed hypertension were screened out and after strictly controlling blood pressure ,completed the ambulatory blood pressure and target organ damage inspection by 1‐year follow‐up .The dynamic changes of AASI and target organ damage were observed .Results After 1‐year anti‐hypertensive therapy ,AASI showed the gradually descending trend ,compared with before treatment ,began to decline at 6 months , decreased significantly after 1 year ;AASI showed the independent positive correlation with the intima‐media thickness(IMT) of ca‐rotid artery ,urine microalbumin(UMA) ,renal vascular resistance index(RRI) and left ventricular mass index(LVMI) ,and inde‐pendent negative correlation with endogenous creatinine clearance rate(Ccr) before and after treatment ;the multiple linear regres‐sion analysis showed that IMT ,UMA ,RRI ,Ccr and LVMI had significant correlation with AASI .After 1 year of therapy ,IMT , UMA ,RRI ,Ccr ,LVMI had shown some improvement(P<0 .05) .Conclusion AASI can be used as an indicator for evaluating arte‐riosclerosis and predicting the target organ damage in hypertension .
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Objective To observe the level of urinary microalbumin(MAU) and carotid artery intima-media thickness(CIMT) in patients with subclinical hypothyroidism,and to explore the relationship between subclinical hypothyroidism and MAU,arteriosclerosis.Methods 70 patients with subclinical hypothyroidism were randomly divided into the two groups according to the level of CIMT.33 patients were selected as the arteriosclerosis group and 37 patients were selected as the non-arteriosclerosis group,and 30 healthy people were selected as the control group.The levels of FT3,FT4,TSH,blood fat,MAU,CIMT observed.Results Compared with the healthy controls,the levels of TC,TG,LDL-C,CIMT were significantly higher in the arteriosclerosis group (P =0.008,0.007,0.009,0.006),the level of HDL-C was significantly lower in the arteriosclerosis group(P =0.006).The levels of TC,TG,LDL-C,CIMT were significantly higher in the non-arteriosclerosis group (P =0.042,0.037,0.008,0.035),the level of HDL-C was significantly lower in the non-arteriosclerosis group(P =0.038).The levels of TC,TG,LDL-C,CIMT in arteriosclerosis group were significantly higher than those in the non-arteriosclerosis group (P =0.032,0.041,0.039,0.007).The level of HDL-C in the arteriosclerosis group was significantly lower than the non-arteriosclerosis group(P =0.044).The level of MAU had no significant difference among the three groups(P =0.052,0.087,0.092).TSH had no relationship with MAU (r =0.195,P ＞ 0.05),TSH had positive correlation with CIMT(r =0.578,P ＜ 0.01).Conclusion The patients with subclinical hypothyroidism have lipid metabolism disorder and CIMT incrassation,which can increase the risk of arteriosclerosis.
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Objective To explore the effect of the combination of benazepril and beraprost sodium on urinary microalbumin (UMA), serum high sensitivity C-reactive protein (hs-CRP) and TNF-α in patients with diabetic nephropathy(DN) in early stage. Methods From Mar. 2010 to Mar. 2013, 120 patients with early-stage DN were randomly divided into Benazepril Group, Beraprost Sodium Group and Combination Group. Each group consisted of 40 patients with medical therapy in 20-week duration. The levels of 24 h-UMA, serum hs-CRP and TNF-α were detected and compared before and after therapy. Results After treatment, the levels of 24 h-UMA, serum hs-CRP and TNF-αall decreased significantly in three groups (P<0.05) and there were lower 24 h-UMA, serum hs-CRP and TNF-αin Combination Group than those in Benazepril Group and Berapros sodium Group (P <0.05). Conclusion There is coordinating protection of combination of benazepril and beraprost sodium on diabetic nephropathy in early stage, possibly being related with the inhibiting of micro-inflammation.
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Objective To study the relation of different TCM syndrome types of hypertension combined with metabolic syndrome (MS) patients with retinal vascular changes and the urinary microalbumin, and provide objective basis for TCM treatment with syndrome differentiation. Methods Seventy-six patients of hypertension combined with MS (divided into four syndrome types) and 20 patients with simple hypertension were selected. General data, biochemical indexes, retinal vascular changes and the urinary microalbumin were detected and compared. Results In patients with hypertension combined with MS, blood lipid disorders and high blood sugar was mainly focused on the type of phlegm and blood stasis mutual and the type of qi and yin deficiency. The incidence of eye and kidney damage in hypertension with MS patients was higher than the simple hypertension patients. The positive rates of retinal blood vessels and renal damage in qi and yin deficiency type and phlegm and blood stasis mutual type were higher than that in other syndrome types. Conclusion Hypertension with MS patients should pay attention to the prevention and control of retinal vascular and renal vascular complications. Fundus examination and detection of early renal damage index can be used as the basis of TCM syndrome differentiation of hypertension with MS.
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Objective To discuss the application value of the combination detection of serum cystatin C(CysC),serum amyloid A (SAA)and urinary microalbumin(malb)for the early diagnosis of diabetic nephropathy(DN).Methods 112 cases of diabetic melli-tus(DM)were selected and divided into the non-DN group(malb<25 mg/L)and the early DN group(malb 30-299 mg/L)according to the urinary microalbumin level.50 cases of healthy subjects were selected as the control group.The levels of serum CysC and malb were measured by immuno-scatter turbidmetry and SAA was measured by enzyme-linked immunosorbent assays(ELISA).At the same time,the biochemical indexes of GLU,Cr,HbA1C were detected too.Results The levels of CysC,SAA and malb in the DM two groups were significantly higher than those in the healthy control group with statistical differences(P <0.05 ),moreover which were increased with the renal damage aggravation;the levels in the early DN group were significantly higher than those in the non-DN group with statistical differences(P <0.05).The levels of GLU and HbA1C in the DM two groups had statistically signifi-cant differences compared with the healthy control group(P <0.05).Conclusion The levels of serum CysC and SAA in the DM pa-tients are increased with the urinary malb level increase.The combined detection of CysC,SAA and malb could increase the diagnos-tic rate of the renal damage in early DN.
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ObjectiveTo investigate the clinical value of serum cystatin C(CysC) and urinary microalbumin(MA) in the diagnosis of early renal function injury in patients with essential hypertension.MethodsOne hundred and twenty patients with essential hypertension(hypertension group) were divided into three groups by the results of blood pressure:grade 1 with 48 cases,grade 2 with 47 cases,grade 3 with 25 cases.Thirty healthy subjects were selected as control group.Serum CysC,urinary MA and serum creatinine (Cr) were detected in all subjects.ResultsThe serum CysC and urinary MA in grade 1,2 and 3 hypertension group [(1.57 ±0.48),(2.12 ±0.72),(2.91 ± 1.09) mg/L and(18.12 ±5.43),(29.01 ±8.07),(46.06 ± 13.21 ) mg/L] were obviously higher than those in control group [ (0.71 ± 0.23 ),(9.35 ±5.17)mg/L](P＜ 0.05).The serum Cr had no significant difference between grade 1,2,3 hypertension group and control group (P ＞ 0.05 ).Serum CysC was positively correlated with urinary MA in hypertension group (r =0.613,P ＜ 0.05),serum CysC and urinary MA were both negatively correlated with estimated glomenlar filtration rate (eGFR)(r=-0.635,-0.563,P＜0.05).ConclusionsSerum CysC and urinary MA are sensitive indexes of early renal function injury in patients with hypertension.The combined determination of serum CysC and urinary MA can improve the detection rate of early renal function injury.
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Objective To investigate the relationship of homocysteine and blood glucose wavy coefficient with type 2 diabetic nephropathy.Methods Glycosylated hemoglobin A1c (HbA1c),fasting blood glucose(FBG),fasting C-peptide,homocysteine(Hcy),blood-fat and 24h urinary albumin quantitative (UAlb) of 154 patients with type 2 diabetes were determined,and the blood glucose wavy coefficient were calculated after blood glucose monitored by a continuous glucose monitoring system (CGMS).The patients were divided into two groups according to the quantity of UAlb:high UAlb group (n =81 ) and normal UAlb group( n =73 ).Then the difference were compared between two groups and multiple regression analysis was done between UAlb and a variety factors.Results The course of disease in high UAlb group were significantly longer than that in normal UAlb group ( (9.68 ± 7.31 ) years vs ( 5.44 ± 3.65 ) years,t =3.427,P ＜ 0.05 ).There were significant difference on HbA1c [ ( 9.61 ± 2.44 ) ％ vs ( 8.69 ± 2.35 ) ％,t =2.162 ],blood glucose wavy coefficient [ ( 3.06 ± 0.85 ) vs (2.58 ± 0.91 ),t =2.437],low density lipoprotein-cholesterol (LDL-C) [ (3.46 ± 0.83 )mmol/L vs ( 3.01 ± 0.84 ) mmol/L,t =2.596 ],UAlb [ ( 129.64 ± 118.5 ) mg/24 h vs ( 18.14 ± 3.54 )mg/24 h,t =6.421 ),UA ( ( 335.02 ± 90.39 ) mmol/L vs ( 287.00 ± 92.03 ) mmol/L,t =2.541 ) and Hcy [ ( 15.55 ± 4.53 ) mmol/L vs ( 13.12 ± 4.44 ) mmol/L,t =2.603 ] between the two groups ( P ＜ 0.05 or P ＜0.01 ).Pearson analysis showed that the courses of disease,LDL-C,UA,Hcy and blood glucose wavy coefficient were positively correlated with UAlb ( r =0.363,0.270,0.220,0.252,0.236 respectively ; P =0.000,0.008,0.033,0.014,0.022,respectively).And the multiple regression analysis indicated that UAlb was related with courses of disease(β =0.344,P =0.000),Hcy(β =0.244,P =0.011 ) and blood glucose wavy coefficient(β =0.229,P =0.012).Conclusion The elevation of serum Hcy and blood glucose wavy coefficient are risk factors to type 2 diabetic nephropathy.Lowering Hcy concentration and reducing the glucose variability may be a new way to prevent the occurrence of type 2 diabetic nephropathy.
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OBJECTIVE:To observe the effect of Ginkgo biloba extract injection on the urinary microalbumin excretion rate in patients with early diabetic nephropathy(DN).METHODS:A total of 84 patients with early DN were randomly divided into two groups:the control group was treated with routine therapy while the treatment group was treated with routine therapy plus Ginkgo biloba extract injection(at a dose of 10mL)q.d for 3 consecutive weeks.The urinary microalbumin excretion rate and the related clinical and biochemical indicators were compared between the two groups before and after treatment.RESULTS:As compared with the control group,urinary microalbumin excretion rate was significantly lowered in the treatment group(P
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Objective To investigate the effects of on-pump and off-pump coronary revascularization on renal function.Methods Twenty four patients underwent elective coronary revascularization were divided into 2 groups: group A with cardiopulmonary bypass(CPB)(n=12) and group B without CPB(n=12).Markers of glomerular and tubular function were evaluated before anesthesia(T_0),at the end of operation(T_1),2 hours after operation(T_2) and 24 hours after operation(T_3).Results The ratio of urinary microalbumin to creatinine and NAG levels increased significantly at T_1 as compared with that at T_0 in on-pump coronary revascularization(P
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BACKGROUND: Non-dipper hypertension is defined as an improper nocturnal blood pressure falling less than 10/5 mmgHg or 10% in systolic and diastolic. Clinical studies have shown that target organ damages tend to be more frequent in non-dipper hypertensives. Author tried to elucidate whether non-dippers in untreated mild to moderate hypertension has more evidence of early renal damage or not. METHODS: Total 141 untreated mild to moderate Korean essential hypertensives including borderline hypertensives and 47 controls were subjected. Diabetes, chronic renal failure, heart failure, severe hypertension (above stage-III by JNC-VI criteria), isolated systolic hypertension and macroproteinuric cases (UAER >200 microgram/mL/min) were excluded to profit this study purpose. Subject was defined as non-dipper when nocturnal blood pressure fall was less than 10/5 mmHg. Urine microalbumin was analyzed by radioimmunoassay, and their excretion rate was calculated according to 24 hr urine volume. All data were compared and analyzed statistically by using of SPSS package. RESULT: Prevalence of non-dipper is not different between both groups (hypertension vs control ; 21.3% vs 25.5%, p>0.05). In hypertensive group, incidence of significant UAER and mean UAER were not different between dipper and non-dipper (all p>0.05). CONCLUSION: In this study, evidence of early renal damage in non-dipper hypertensive was not differ from dipper hypertensives. Long-term study would be necessary to observe for further renal damage in non-dipper hypertensives.