Relevance between renal dysfunction and serum homocysteine in type 2 diabetic patients with normal urinary albumin-to-creatinine ratio

Miao Yanju; Zhou Yingsheng

doi:10.3760/j.issn.1673-4777.2018.09.014

Abstract：Objective To explore the relevance between renal dysfunction and serum homocysteine(Hcy)in type 2 diabetic patients with normal urinary albumin-to-creatinine ratio (ACR).Methods Clinical data of 343 type 2 diabetic patients with normal ACR admitted in Department of Endocrinology and Metabolism,Beijing Anzhen Hospital,Capital Medical University from January to December 2015 were retrospectively analyzed.The patients were divided into 2 groups according to the value of estimated glomerular filtration rate(eGFR) calculated by the formula of Cooperating Group of Chronic Kidney Disease(CKD):eGFR ≥90 ml/(min · 1.73 m2) was defined as normal renal function (stage 1 CKD),eGFR 60-89 ml/(min · 1.73 m2) was defined as early renal injury (stage 2 CKD).Hcy level and clinical indicators were tested in all patients.The correlation between clinical indicators and renal dysfunction was analyzed by binary Logistic regression.Results Hcy level in early renal injury group was higher than that in normal renal function group [(15 ± 6) μmol/L vs (12 ± 6) μmol/L](P ＜ 0.01).The prevalence rate of hyper-Hcy was 37.1％ (39/105) in early renal injury group,which is higher than that in normal renal function group[17.2％ (41/238)] (P ＜ 0.05).In early renal injury group,age was older,abdominal circumference was larger,ratios of male,hypertension,coronary atherosclerotic heart disease,stroke history,systolic pressure,fasting insulin and blood uric acid level were higher,the course of diabetes was longer,diastolic blood pressure and triglyceride level were lower than those in normal renal function group(all P ＜0.05).Logistic regression showed that hyper-Hcy was associated with an approximate 2.342-fold greater risk of renal dysfunction (95 ％ confidence interval:1.276-4.297,P =0.006).Conclusion There is a high prevalence of hyper-Hcy in type 2 diabetic patients with normal ACR,and hyper-Hcy is an independent risk factor of early renal dysfunction.