Study on the diagnostic value of serum C-peptide and NLR combined with renal artery resistance index in type 2 diabetic nephropathy

Objective: To explore the diagnostic value of serum C-peptide(C-P), neutrophil to lymphocyte ratio(NLR) and renal artery resistance index(RI) in patients with type 2 diabetic nephropathy(DN). Methods: A total of 216 patients with type 2 diabetes mellitus were divided into the DN group(129 cases) and non-DN (NDN) group(87 cases).Within 24 hours after admission, the general clinical data of two groups were collected and analyzed.The blood related indicators, renal function indicators, serum C-P, NLR and other indicators were detected, and the RI values were measured using color Doppler ultrasound.The differences in relevant indicators between two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of DN patients, and Pearson correlation analysis was used to analyze the correlation between serum C-P, NLR and RI and DN.The diagnostic value of single detection and combined detection of serum C-P, NLR and RI for DN was evaluated based on the area under the receiver operating characteristic(ROC) curve. Results: The results of univariate analysis showed that the diabetes course, incidence of diabetic retinopathy and serum levels of SCr, BUN, NLR and RI in the DN group were significantly higher than those in NDN group(P < 0.05), and the serum levels of C-P and eGFR were significantly lower than those in NDN group(P < 0.05).The results of multivariate logistic regression analysis showed that the longer course of diabetes, combination of diabetic retinopathy, increase of serum NLR and RI and decrease of C-P and eGFR levels were the main influencing factors of DN.According to Pearson correlation analysis, the serum C-P expression was negatively correlated with DN(r=-0.298, P < 0.01), while the NLR and RI were positively correlated with DN(r=0.421, P < 0.01;r=0.382, P < 0.01).The ROC curve results showed that the AUC of combined detection of serum C-P, NLR and RI for diagnosis of DN were higher than that of each index alone(P < 0.05). Conclusions: The serum C-P, NLR and RI have good diagnostic value for DN.Among them, the decrease of serum C-P level value, increase of NLR level value and RI value are the influencing factors leading to DN.Clinically, intervention should be carried out as early as possible based on the detection results of the above indicators.In addition, the combined detection of the levels of the three has a higher diagnostic efficacy for DN than the detection of a single indicator.