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Objective: Homocysteine ??is an intermediate product of methionine metabolism, plasma levels are affected by many factors, in patients with impaired renal function of its concentration and serum creatinine levels are closely related. The purpose of this project is to investigate the plasma Hcy levels in patients with diabetic nephropathy (DN) with micro-inflammatory state, malnutrition, provide objective research based on the AS relationship between its incidence in the DN progress, deterioration and prognosis, to guide clinical diagnosis and treatment of work . Methods: The subjects were 73 cases of type 2 diabetes mellitus patients with diabetic nephropathy (DN) over five years, according to the level of endogenous creatinine clearance rate is divided into stage Ⅳ diabetic nephropathy (clinical nephropathy) and Ⅴ of diabetic nephropathy (uremia) two group. Ⅴ of diabetic nephropathy group of 36 patients, the level of endogenous creatinine clearance (Ccr) <60ml/mim; Ⅳ diabetic nephropathy, 37 cases, serum creatinine (Scr) in the normal range (22 to 133 micromol / L), Ccr> 60ml / min. Determination of the observer plasma homocysteine ??(Hcy), high-sensitivity C-reactive protein (Hs-CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), serum prealbumin (PA), serum albumin ( ALB) levels and carotid intima-media thickness (IMT) and traditional atherosclerosis (AS) factors of high-density lipoprotein (HDL), triglycerides (TG), cholesterol (CHO) levels. Selected 34 age and sex-matched healthy population control group. The results obtained using multivariate analysis of variance, t-test and single-factor correlation analysis for statistical analysis, P <0.05 for the difference was significant. Results: diabetic nephropathy (DN) between patients and healthy population, the differences in Hcy, Hs-CRP, Hb, PA, ALB, and other indicators of the level of significant forward, significant of Ⅴ period diabetes nephropathy group and Ⅳ period of diabetic nephropathy group various indicators of differences; in DN patients low protein the hyperlipidemia group Hcy level is a significant difference (P <.0001), the former of these parameters were significantly elevated compared with normal serum albumin; abnormal rise in DN patients Hs-CRP group and the normal group of Hs-CRP Hcy levels significantly different ( P <.0001), the former was significantly higher; compare Hcy levels of abnormally elevated group DN patients IMT IMT normal group was significantly different (P <.0001), and the former was significantly higher; significantly higher Hcy levels of residual renal function in DN patients in residual renal function group, the difference was significant (P <.0001). Correlation analysis showed that DN patients body Hcy Hb, ALB, PA, Ccr was negatively correlated (respectively r = -0.50, P <.0001; r = -0.43, P <.0001; r = 0.32, P = 0.01 ; r = 0.39, P = 0.0007), and a positive correlation between Hs-CRP, ESR, IMT, CHO (respectively r = -0.52, P <.0001; r = -0.56, P <.0001; r = 0.54, P <.0001; r = 0.26, P = 0.03), and HDL, TG no correlation (r = -0.12, P = 0.30 and r = 0.15, P = 0.19). Conclusion: the body of patients with diabetic nephropathy HHcy, malnutrition, state of microinflammatory, AS interaction of multiple factors play an important role in the occurrence and progression of DN. HHcy was negatively correlated with malnutrition, and a positive correlation between micro-inflammatory state and arteriosclerosis. Combined detection of blood Hcy, Hs-CRP, PA, Hb, ALB levels to assess the degree of arteriosclerosis in the body, compared with IMT detection convenient economic assessment DN condition of the patient's condition, prognosis of significant value, as the progress of the disease to determine and therapeutic indicators. Reduce plasma Hcy levels sense, drug intervention in diabetic nephropathy in patients with renal impairment, early onset of the theoretical basis.
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