Volume 45 Issue 4
Apr.  2024
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Mengxue LIU, Jia MIAO, Xuehe SHENG. Correlation between Blood UA,Smad1 Protein,Urine mALB Levels and the Therapeutic Effect of Dapagliflozin in Patients with Type 2 Diabetes Nephropathy[J]. Journal of Kunming Medical University, 2024, 45(4): 170-176. doi: 10.12259/j.issn.2095-610X.S20240425
Citation: Mengxue LIU, Jia MIAO, Xuehe SHENG. Correlation between Blood UA,Smad1 Protein,Urine mALB Levels and the Therapeutic Effect of Dapagliflozin in Patients with Type 2 Diabetes Nephropathy[J]. Journal of Kunming Medical University, 2024, 45(4): 170-176. doi: 10.12259/j.issn.2095-610X.S20240425

Correlation between Blood UA,Smad1 Protein,Urine mALB Levels and the Therapeutic Effect of Dapagliflozin in Patients with Type 2 Diabetes Nephropathy

doi: 10.12259/j.issn.2095-610X.S20240425
  • Received Date: 2023-12-21
    Available Online: 2024-04-06
  • Publish Date: 2024-04-29
  •   Objective  To observe the levels of uric acid, Smad1 protein, and urine microalbumin in patients with type 2 diabetic nephropathy, and to analyze the correlation between these three factors and the effectiveness of dapagliflozin in treating type 2 diabetic nephropathy.  Methods  From June 2021 to September 2022, 170 patients with type 2 diabetic nephropathy in our hospital were included in the diabetic nephropathy group. Another 120 patients with only type 2 diabetes during the same period were included in the simple diabetes group. All patients underwent blood UA, Smad1 protein, and urine mALB tests upon admission, and the levels of these three indicators were compared between the diabetic nephropathy group and the simple diabetes group. All type 2 diabetic nephropathy patients were treated with dapagliflozin and followed up for three months to observe the treatment effect. Based on the treatment effect, they were divided into the effective group (n = 142) and the ineffective group (n = 28). The blood UA, Smad1 protein and urine mALB contents of the effective group and ineffective group were compared, and the correlation between the three indexes and the therapeutic effect of Dapagliflozin on type 2 diabetic nephropathy was analyzed. A receiver operating characteristic curve (ROC) was plotted to analyze the predictive value of the above three indicators for the effect of dapagliflozin treatment for type 2 diabetic nephropathy.   Results  Diabetic nephropathy group had higher levels of blood UA, Smad1 protein, and urine mALB compared to the simple diabetic group (t = 8.843, 12.097, 8.858, P < 0.05). After 3 months of treatment, out of 170 type 2 diabetic nephropathy patients, 142 cases were effectively treated (83.53%), while 28 cases were not (16.47%). The ineffective group had higher levels of blood UA, Smad1 protein, and urine mALB compared to the effective group (t = 3.508, 4.622, 3.563, P < 0.05). Correlation analysis showed that blood UA, Smad1 protein, and urine mALB levels were negatively correlated with the efficacy of Dapagliflozin treatment for type 2 diabetic nephropathy (r = -0.261, -0.336, -0.265, P < 0.05). Logistic regression analysis indicated that elevated levels of blood UA (95%CI: 1.001~1.021), Smad1 protein (95%CI: 1.167~1.610), and urine mALB (95%CI: 1.011~1.048) were risk factors for the ineffectiveness of Dapagliflozin treatment for type 2 diabetic nephropathy (OR=1.011, 1.371, 1.029, P < 0.05). The receiver operator characteristic curve (ROC) analysis showed that blood UA (95%CI: 0.622~0.793), Smad1 protein (95%CI: 0.685~0.841), and urine mALB (95%CI: 0.630~0.803) levels had some predictive value for the efficacy of Dapagliflozin treatment for type 2 diabetic nephropathy (AUC = 0.707, 0.763, 0.716), with higher predictive value when combined (95%CI: 0.734~0.881, AUC = 0.808).  Conclusion  The levels of serum UA, Smad1 protein and urine mALB are closely related to the therapeutic effect of Dapagliflozin on type 2 diabetic nephropathy, which can be used to predict its therapeutic effect.
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