Aims

Diabetic Nephropathy (DN) is a complication of Diabetes Mellitus and is associated with chronic and low-grade inflammatory burden. Novel inflammatory predictors, such as, C-reactive protein to serum albumin ratio (CAR) has been studied various inflammatory conditions, recently. Increased inflammatory burden accompany to both type 2 Diabetes Mellitus (T2DM) and DN, hence we aimed to compare CAR levels of the T2DM subjects with DN to those of without DN.

Methods

Patients with T2DM were enrolled to the study. Study population grouped into two according to the presence (group A) or absence (group B) of DN. Characteristics and laboratory data, as well as CAR levels; of the study groups were compared.

Results

Median CAR levels of the groups A and B were 2.17% (0.02−13.2) and 0.39% (0.02−4.39), respectively (p < 0.001). CAR was found to be an independent risk factor for diabetic nephropathy (adjusted to age, BMI, fasting glucose, HbA1c, and body weight). One unit (0.1%) elevation in CAR increased the risk of nephropathy by 3.5 folds (p < 0.001, 95%CI: 2.24–5.45). CAR levels greater than 0.82% have 79% sensitivity and 78% specificity in predicting DN (AUC: 0.86 [95% CI: 0.80−0.92]; p < 0.001).

Conclusions

In conclusion, elevated CAR levels are higher in type 2 diabetic patients with diabetic nephropathy. According to the ROC curve, a level higher than 0.82% presents the best sensitivity and specificity in the association with the presence of DN.

中文翻译：

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C 反应蛋白与血清白蛋白的比率是否与 2 型糖尿病患者的糖尿病肾病相关？护理时间研究

目标

糖尿病肾病 (DN) 是糖尿病的一种并发症，与慢性和低度炎症负担有关。新的炎症预测因子，例如 C 反应蛋白与血清白蛋白比率 (CAR)，最近已在各种炎症条件下进行了研究。2 型糖尿病 (T2DM) 和 DN 都伴随着增加的炎症负担，因此我们旨在比较 DN 与没有 DN 的 T2DM 受试者的 CAR 水平。

方法

患有 T2DM 的患者被纳入该研究。根据 DN 的存在（A 组）或不存在（B 组）将研究人群分为两组。特征和实验室数据，以及 CAR 水平；的研究组进行了比较。

结果

A 组和 B 组的中位 CAR 水平分别为 2.17% (0.02-13.2) 和 0.39% (0.02-4.39) ( p < 0.001)。发现 CAR 是糖尿病肾病的独立危险因素（根据年龄、BMI、空腹血糖、HbA1c 和体重调整）。CAR 升高一个单位（0.1%）会使肾病风险增加 3.5 倍（p < 0.001，95%CI：2.24-5.45）。大于 0.82% 的 CAR 水平在预测 DN 方面具有 79% 的敏感性和 78% 的特异性（AUC：0.86 [95% CI：0.80-0.92]；p < 0.001）。

结论

总之，患有糖尿病肾病的 2 型糖尿病患者的 CAR 水平升高。根据 ROC 曲线，高于 0.82% 的水平代表与 DN 存在关联的最佳敏感性和特异性。