Study on the correlation of type 2 diabetic nephropathy and coronary heart disease.

Objective To discuss the prevalence of coronary heart disease between type 2 diabetic patients with and without nephropathy and its related risk factors. Methods 295 patients with type 2 diabetes mellitus were divided into nephropathy (DN) group and non-nephropathy (N-DN) group according to the Mogensen's diabetic nephropathic diagnostic criteria. The sex, age, duration of the disease, smoking history, body mass index (BMI), HbA1C, blood pressure, blood lipid, serum uric acid (UA), plasma fibrinogen (FIB), serum creatine and creatine clearance (CCr), 24 hours urinary microalbumin (uMA) and the morbidity of coronary heart disease between two groups were compared, as well as the correlation between type 2 diabetic nephropathy and coronary heart disease was analyzed with logistic regression. Results Cr (97.17 vs. 71.34) and uMA(279.56 vs. 14.56) of the DN group were higher than that of the N-DN group, and CCr was lower than that of the N-DN group (94.82 vs. 121.94(all P0.01). Compared with N-DN group, DN group had a higher morbidity of coronary heart disease (57.33% vs.38.62%, P0.01), a longer duration of the diabetes and higher blood pressure, cholesterol(TC), low dense lipoprotein cholesterol(LDL-C), UA and FIB level(P0.05). Univariate logistic regression analysis suggested there were significant positive correlations of diabetic nephropathy with duration of the disease, blood pressure, TC, LDL-C, UA and FIB. Multivariate logistic regression analysis demonstrated that CCr(OR=0.987, 95%CI:0.987～ 0.996), age (OR=1.040, 95%CI:1.015～1.065), and SBP (OR=1.017, 95%CI: 1.005～1.029) were independent risk factors for coronary heart disease. Conclusion Type 2 diabetic nephropathic patients were prone to a higher prevalence of coronary heart disease and a higher level of cardiovascular risk factors. The reduction of CCr was an independent risk factor of coronary heart disease.