Correlation between hyperhomocysteinemia and early renal disease in patients with type 2 diabetes mellitus

doi:10.3969/j.issn.1004-583X.2023.01.004

Abstract

Abstract:

Objective To study the effect of hyperhomocysteinemia on the risk of early renal disease in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods It was a retrospective study involving 306 T2DM patients admitted to Nanjing Jiangbei Hospital from October 2020 to June 2022. According to the diagnostic criteria of diabetic kidney disease (DKD), they were assigned into simple T2DM group ( $n$ =252) and early DKD group ( $n$ =54). The clinical data of the two groups were compared. Results The prevalence of early DKD in T2DM patients was 17.6%. Compared with those of simple T2DM group, T2DM patients in early DKD group were significantly older, with longer duration of T2DM, higher level of homocysteine, and higher proportions of hyperhomocysteinemia and hypertension (all $P$ <0.05). Multivariate logistic regression analysis showed that hyperhomocysteinemia significantly increased the risk of early DKD in T2DM patients by 5.361 times ( $O R$ =6.361, 95% $C I$ : 3.043-13.296, $P$ <0.05), and the level of homocysteine was dose-dependently correlated with the risk of early DKD in T2DM patients, that was, for every 1 μmol/L increase in homocysteine level, the risk of early DKD in T2DM patients increased by 14.1%( $O R$ =1.141, 95% $C I$ : 1.061-1.227, $P$ <0.05). Conclusion Hyperhomocysteinemia in T2DM patients significantly increases the risk of early DKD, and the level of homocysteine has a dose-response relationship with the increased risk of early DKD.

Key words: diabetes mellitus, type 2, diabetic nephropathies, hyperhomocysteinemia

CLC Number:

R587.1

Wang Cui, Lin Hao, Wu Pingping, Zhang Yali, Ren Jian, Xu Ting, Dong Guoyu, Zai Guotian. Correlation between hyperhomocysteinemia and early renal disease in patients with type 2 diabetes mellitus[J]. Clinical Focus, 2023, 38(1): 42-45.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.01.004

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I1/42

Figures/Tables 2

Tab.1 Comparison of general data and laboratory data between groups

组别		例数	年龄 (岁)		男性 [例(%)]		糖尿病病程 (年)		目前饮酒 [例(%)]		目前吸烟 [例(%)]		高Hcy血症 [例(%)]		高血压病史 [例(%)]		心脏病病史 [例(%)]		脑梗死病史 [例(%)]
早期DKD组		54	62.00±15.74		35(64.8)		10.54±5.80		7(13.0)		11(20.4)		22(40.7)		46(85.2)		3(5.6)		17(31.5)
单纯T2DM组		252	55.49±13.16		166(65.9)		7.30±6.71		41(16.3)		65(25.8)		24(9.5)		157(62.3)		28(11.1)		51(20.2)
统计值			$t$ =3.18		χ²=0.02		$t$ =3.29		χ²=0.37		χ²=0.70		χ²=33.93		χ²=10.43		χ²=1.51		χ²=3.25
$P$ 值			0.001		0.882		0.001		0.544		0.403		0.000		0.001		0.220		0.071
组别	BMI (kg/m²)			FPG (mmol/L)		HbA₁c (mmol/L)		SBP (mmHg)		DBP (mmHg)		TC (mmol/L)		HDL-C (mmol/L)		LDL-C (mmol/L)		TG (mmol/L)		Hcy (μmol/L)
早期DKD组	25.81±4.16			9.31±3.88		9.37±2.05		140.50±15.87		78.41±10.83		4.42±1.36		1.13±0.46		2.51±1.00		2.28±2.24		16.01±13.15
单纯T2DM组	25.53±4.45			9.32±2.76		9.48±2.17		135.83±17.78		80.38±10.99		4.62±1.26		1.07±0.24		2.77±0.94		1.91±1.73		11.11±4.29
统计值	$t$ =0.42			$t$ =0.03		$t$ =0.32		$t$ =1.78		$t$ =1.20		$t$ =1.07		$t$ =0.80		$t$ =1.80		$t$ =1.13		$t$ =2.71
$P$ 值	0.678			0.979		0.748		0.076		0.230		0.287		0.427		0.073		0.264		0.009

Tab.1 Comparison of general data and laboratory data between groups

组别		例数	年龄 (岁)		男性 [例(%)]		糖尿病病程 (年)		目前饮酒 [例(%)]		目前吸烟 [例(%)]		高Hcy血症 [例(%)]		高血压病史 [例(%)]		心脏病病史 [例(%)]		脑梗死病史 [例(%)]
早期DKD组		54	62.00±15.74		35(64.8)		10.54±5.80		7(13.0)		11(20.4)		22(40.7)		46(85.2)		3(5.6)		17(31.5)
单纯T2DM组		252	55.49±13.16		166(65.9)		7.30±6.71		41(16.3)		65(25.8)		24(9.5)		157(62.3)		28(11.1)		51(20.2)
统计值			$t$ =3.18		χ²=0.02		$t$ =3.29		χ²=0.37		χ²=0.70		χ²=33.93		χ²=10.43		χ²=1.51		χ²=3.25
$P$ 值			0.001		0.882		0.001		0.544		0.403		0.000		0.001		0.220		0.071
组别	BMI (kg/m²)			FPG (mmol/L)		HbA₁c (mmol/L)		SBP (mmHg)		DBP (mmHg)		TC (mmol/L)		HDL-C (mmol/L)		LDL-C (mmol/L)		TG (mmol/L)		Hcy (μmol/L)
早期DKD组	25.81±4.16			9.31±3.88		9.37±2.05		140.50±15.87		78.41±10.83		4.42±1.36		1.13±0.46		2.51±1.00		2.28±2.24		16.01±13.15
单纯T2DM组	25.53±4.45			9.32±2.76		9.48±2.17		135.83±17.78		80.38±10.99		4.62±1.26		1.07±0.24		2.77±0.94		1.91±1.73		11.11±4.29
统计值	$t$ =0.42			$t$ =0.03		$t$ =0.32		$t$ =1.78		$t$ =1.20		$t$ =1.07		$t$ =0.80		$t$ =1.80		$t$ =1.13		$t$ =2.71
$P$ 值	0.678			0.979		0.748		0.076		0.230		0.287		0.427		0.073		0.264		0.009

Tab.2 Logistic regression analysis of risk factors of early DKD in T2DM patients

因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	95% $C I$
因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	下限	上限
高Hcy血症	0.365	0.376	24.191	0.000	6.361	3.043	13.296
高血压病史	0.211	0.430	3.544	0.060	2.247	0.967	5.222
Hcy	0.132	0.037	12.575	0.000	1.141	1.061	1.227
糖尿病病程	0.064	0.026	5.902	0.015	1.066	1.012	1.123
年龄	0.015	0.014	1.131	0.288	1.015	0.988	1.043

Tab.2 Logistic regression analysis of risk factors of early DKD in T2DM patients

因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	95% $C I$
因素	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	下限	上限
高Hcy血症	0.365	0.376	24.191	0.000	6.361	3.043	13.296
高血压病史	0.211	0.430	3.544	0.060	2.247	0.967	5.222
Hcy	0.132	0.037	12.575	0.000	1.141	1.061	1.227
糖尿病病程	0.064	0.026	5.902	0.015	1.066	1.012	1.123
年龄	0.015	0.014	1.131	0.288	1.015	0.988	1.043

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