Correlation Between Serum MDA,FFA and Clinical Prognosis in Patients with Diabetic Kidney Disease

YU Erfeng

doi:10.3969/j.issn.1004-437X.2026.08.020

Abstract：Objective To analyze the correlation between serum malondialdehyde(MDA),free fatty acid(FFA)and the clinical prognosis of patients with diabetic kidney disease(DKD).Methods A total of 116 DKD patients treated at the First People's Hospital of Zhumadian from June 2020 to May 2022 were included in the study.All patients underwent serum MDA and FFA testing upon enrollment.Clinical prognosis was defined based on whether the disease had progressed after 2 years of treatment,and patients were divided into a progressive group and a non progressive group.After comparing the data between groups,a logistic regression was used to test the relationship between the primary outcome measures and the clinical outcomes in DKD patients.The receiver operating characteristic(ROC)curve was drawn to analyze the utility of serum MDA and FFA in predicting clinical prognosis of DKD patients,and to analyze the interactive effect of serum MDA and FFA on clinical prognosis of DKD patients.Results A total of 106 patients completed follow-up.At a 2-year follow-up,33 patients showed evidence of progressive or irreversible DKD,with a cumulative progression rate of 31.13％.The proportion of grade Ⅲ glomerular pathology,renal tubulointerstitial and vascular damage pathology score(RPS)7-9 in the progressive group was higher than that in the non progressive group.At the time of treatment,the levels of glycated hemoglobin(HbA1c),serum cystatin C(Cys C),MDA,and FFA were higher than those in the non progressive group(P＜0.05).The results of logistic regression analysis showed that the clinical prognosis of DKD patients may be related to the patient's glomerular pathological grade,RPS score,HbA1c,serum Cys C,MDA,and FFA(P＜0.05).ROC curve was drawn,and the area under the curve for predicting the progression of DKD patients after treatment with serum MDA and FFA was 0.780 and 0.787,with corresponding optimal thresholds of 10.820 nmol·L-1 and 513.170 μmol·L-1,respectively.The interaction test results showed that serum MDA and FFA had a positive interaction on the clinical prognosis of DKD patients,and the risk of DKD progression caused by the interaction accounted for 79.30％of the total risk.Conclusion The disease progression of DKD patients within 2 years of treatment may be related to abnormal elevation of serum MDA and FFA levels.Pretreatment detection of serum MDA and FFA levels has significance in predicting the risk of DKD disease progression.