Relationship between serum Hcy,NLR and CAR and renal damage in patients with type 2 diabetes mellitus and hypothyroidism
Objective To investigate the relationship between serum homocysteine(Hcy),neu-trophil/lymphocyte ratio(NLR)and C-reactive protein/albumin ratio(CAR)and renal damage in patients with type 2 diabetes mellitus with hypothyroidism.Methods A total of 314 patients diagnosed with type 2 diabetes mellitus,hypothyroidism,and kidney damage were selected from Shandong Provincial Third Hospital from January 2021 to June 2022.This group included 112 patients in the mild group,98 patients in the moderate group and 104 patients in the severe group.Additionally,104 patients with type 2 diabetes mellitus and hypo-thyroidism but without kidney damage during the same period were selected as the non-kidney damage group.Serum levels of Hcy,NLR and CAR were compared among all groups.Relevant data was collected,and sin-gle and multi-factor analyses was conducted to assess the impact of kidney damage in patients with type 2 dia-betes mellitus and hypothyroidism.ROC curve was drawn to verify the predictive value of serum Hcy,NLR,CAR for kidney damage in patients with type 2 diabetes mellitus and hypothyroidism.Results The results of serum Hcy,NLR and CAR levels in patients with different degrees of renal damage were as follows:severe group>moderate group>mild group>non-renal damage group(F=147.431,97.233,324.788,P<0.05).There were significant differences in age,diabetes course,fasting blood glucose,SCr,BUN,TSH,FT3,FT4,Hcy,NLR and CAR levels between the renal lesion group and the non-renal lesion group(χ2=9.953,7.092,t=5.197,4.992,3.425,10.966,2.171,2.112,15.822,9.928,17.407,P<0.05).Logistic regression analy-sis showed that older age,increased levels of SCr,TSH,Hcy,NLR and CAR were independent risk factors for renal damage in patients with diabetes mellitus and hypothyroidism(P<0.05).ROC curve results showed that serum Hcy,NLR,CAR and the combined AUC were 0.898,0.805,0.915 and 0.962,respectively.The prediction efficiency was good(P<0.05).Conclusion Serum Hcy,NLR and CAR levels in patients with type 2 diabetes and hypothyroidism are closely related to the occurrence and development of kidney damage.This in-formation can provide guidance for early prevention and treatment of kidney damage in these patients.
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