Application of combined detection of glycosylated hemoglobin and urinary microalbumin in diagnosis of elderly early diabetes nephropathy

Qi Ting

doi:10.3969/j.issn.1674-7151.2024.01.008

Abstract：Objective To explore the application value of combined detection of glycosylated hemoglobin(HbA1c)and urinary microalbumin(UMA)in diagnosis of elderly early diabetes nephropathy.Methods The 100 patients with type 2 diabetes mellitus(T2DM)accompanied with kidney injury and 100 patients with T2DM who were treated in Gangcheng District People's Hospital from January 2021 to June 2023 were selected as research objects and respectively included in kidney injury group and ssimple diabetes group,and 100 healthy people were selected as control group.The levels of blood urea nitrogen(BUN),serum creatinine(SCr),HbA1c,UMA and urinary creatinine(UCr)of each group were detected,the urinary microalbumin/creatinine ratio(ACR)was calculated,and the differences in the levels of above indicators among the groups were compared.The patients with T2DM combined with renal injury were treated with hypoglycemic drugs and benazepril,and the levels of above indexes in patients before and after treatment were compared.Results The levels of BUN,SCr and HbA1c in renal injury group and simple diabetes group were significantly higher than those in control group[BUN(mmol/L):8.38±1.73,8.04±1.56 vs.5.21±1.20;SCr(μmol/L):94.57±15.20,92.03±14.45 vs.61.74±7.95;HbA1c:0.079±0.013,0.077±0.013 vs.0.050±0.008;all P＜0.05],but there were no significant differences in the levels of BUN,SCr and HbA1c between kidney injury group and simple diabetes group(all P＞0.05).The levels of UMA and ACR in kidney injury group were significantly higher than those in simple diabetes group and control group[UMA(mg/L):41.57±9.20 vs.29.03±5.62,18.74±2.95;ACR(g/mol):32.95±5.63 vs.25.89±4.54,17.31±3.28;all P＜0.05],and the levels of UMA and ACR in simple diabetes group were significantly higher than those in control group(all P＜0.05).The levels of BUN,SCr,HbA1c,UMA and ACR in patients with T2DM combined with kidney injury after treatment were significantly lower than those before treatment[BUN(mmol/L):8.38±1.73 vs.6.29±1.32;SCR(μmol/L):94.57±15.20 vs.74.31±10.08;HbA1c:0.079±0.013 vs.0.064±0.011;UMA(mg/L):41.57±9.20 vs.29.74±7.69;ACR(g/mol):32.95±5.63 vs.26.19±4.37;all P＜0.05].Conclusions The levels of HbA1c,UMA and ACR are all increased in patients with T2DM.In particular,UMA and ACR could sensitively reflect the renal injury in patients with T2DM,which could be used as auxiliary diagnostic indicators for early diagnosis,and could also evaluate the treatment effect of renal injury in patients with T2DM.