Analysis of influencing factors on renal parenchymal elasticity in diabetic patients with hypertension

doi:10.3877/cma.j.issn.1672-6448.2019.01.012

Abstract

Abstract:

Objective

To investigate the factors affecting renal parenchymal elasticity in diabetic patients with hypertension.

Methods

According to the presence of diabetes and hypertension, 167 patients were divided into three groups: simple diabetes mellitus (DM) group, simple hypertension (HP) group and diabetes mellitus combined with hypertension (DM+ HP) group. Meanwhile, 50 healthy volunteers were selected as control group. The basic clinical data of subjects were collected, routine laboratory tests were detected, and virtual touch quantization (VTQ) was used to measure the left renal shear wave velocity (SWV). Then one-way ANOVA was used to analyze the measurement parameters among the above groups, and the relationship between SWV values and various factors was analyzed by multiple stepwise linear regression analysis.

Results

For SWV, there was significant difference among 4 groups. The SWV values in group DM+ HP were greater than that in group DM and group HP [(2.62±0.35) m/s vs (2.44±0.32) m/s, (2.62±0.35) m/s vs (2.49±0.27) m/s], the differences were statistically significant (t=-2.854, -2.198, all P<0.05). And all three patient groups had greater values of renal SWV than that of control group [(2.01±0.22) m/s], the differences were statistically significant (t=-7.854, -9.783, -10.787, all P<0.05). Multiple linear regression analysis showed that SWV had linear relationship with duration of diabetes, duration of hypertension, left renal parenchymal thickness, left renal artery blood flow resistance index (RI) and uric acid (standard regression coefficient b′=0.488, 0.159, -0.187, 0.151, 0.123, P<0.05, respectively). In details, SWV was positively correlated with duration of diabetes, duration of hypertension, left renal artery blood flow RI and uric acid, while negatively correlated with the left renal parenchymal thickness.

Conclusions

The main factors related to the elasticity of renal parenchyma were duration of diabetes, duration of hypertension, left renal parenchymal thickness, left renal artery blood flow RI and uric acid, which can be helpful for clinical prevention for renal parenchymal change in diabetic patients with hypertension.

Manjing Ye, Yan Jiao, Xiuyun Li, Chao Zheng, Yaping Zhao, Chunpeng Zou. Analysis of influencing factors on renal parenchymal elasticity in diabetic patients with hypertension[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(01): 48-53.

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References 15

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组别	例数	男性/女性	年龄（岁）	SWV（m/s）	UAER（mg/24h）	糖尿病病程（年）	高血压病程（年）	左肾动脉主干血流RI
健康对照组	50	21/29	58.04±11.92	2.01±0.22	3.85±0.65	0	0	0.65±0.06
DM组	51	27/24	59.88±11.81	2.44±0.32^a	457.25±311.92^a	7.92±5.52^a	0	0.72±0.08^a
HP组	51	28/23	58.76±14.69	2.49±0.27^b	495.61±354.77^b	0^d	10.99±9.02^bd	0.71±0.06^b
DM＋HP组	65	28/37	61.74±11.81	2.62±0.35^cef	1163.72±535.77^cef	10.54±7.42^cef	9.06±8.05^ce	0.74±0.12^c
F值	?	?	0.959	42.040	95.857	69.700	46.731	10.764
P值	?	?	0.413	<0.001	<0.001	<0.001	<0.001	<0.001
组别	例数	左肾体积（ml）	左肾实质厚度（mm）	收缩压（mmHg）	舒张压（mmHg）	尿肌酐（mmol/L）	尿素氮（mmol/L）	血肌酐（μmol/L）
健康对照组	50	116.30±15.47	14.28±3.12	106.35±15.68	72.55±8.36	6.86±2.34	5.59±1.98	55.58±13.50
DM组	51	110.08±17.25	12.66±2.21^a	110.42±18.75	75.72±10.23	4.93±2.83^a	5.57±1.32	52.04±10.60
HP组	51	112.49±17.99	12.86±2.29	158.88±17.62^bd	80.76±14.67^bd	5.05±2.89^b	5.87±1.67	74.93±28.27^bd
DM＋HP组	65	114.11±19.07	12.40±2.09^c	161.44±16.38^ce	79.88±13.95^c	5.46±2.90^c	6.48±2.54^ce	84.80±49.51^ce
F值	?	1.134	6.308	165.835	5.099	5.186	2.750	13.938
P值	?	0.336	<0.001	<0.001	0.002	0.002	0.044	<0.001
组别	例数	Ccr（ml/min）	TG（mmol/L）	HDL（mmol/L）	LDL（mmol/L）	HBA1C	尿酸（μmol/L）
健康对照组	50	101.72±16.13	1.36±0.63	1.08±0.25	2.44±0.68	5.21±0.58	301.82±57.13
DM组	51	95.94±23.66	1.41±0.73	1.05±0.23	2.62±0.77	9.35±1.71^a	305.54±67.57
HP组	51	87.29±28.51^b	2.12±0.98^bd	1.12±0.33	2.87±0.83^b	5.43±0.62^d	376.67±84.02^bd
DM＋HP组	65	77.10±32.66^ce	1.81±1.26^ce	1.21±0.59	2.92±1.10^c	8.65±1.74^cf	350.62±102.55^ce
F值	?	9.405	7.184	1.818	3.531	137.828	10.228
P值	?	<0.001	<0.001	0.145	0.016	<0.001	<0.001

组别	例数	男性/女性	年龄（岁）	SWV（m/s）	UAER（mg/24h）	糖尿病病程（年）	高血压病程（年）	左肾动脉主干血流RI
健康对照组	50	21/29	58.04±11.92	2.01±0.22	3.85±0.65	0	0	0.65±0.06
DM组	51	27/24	59.88±11.81	2.44±0.32^a	457.25±311.92^a	7.92±5.52^a	0	0.72±0.08^a
HP组	51	28/23	58.76±14.69	2.49±0.27^b	495.61±354.77^b	0^d	10.99±9.02^bd	0.71±0.06^b
DM＋HP组	65	28/37	61.74±11.81	2.62±0.35^cef	1163.72±535.77^cef	10.54±7.42^cef	9.06±8.05^ce	0.74±0.12^c
F值	?	?	0.959	42.040	95.857	69.700	46.731	10.764
P值	?	?	0.413	<0.001	<0.001	<0.001	<0.001	<0.001
组别	例数	左肾体积（ml）	左肾实质厚度（mm）	收缩压（mmHg）	舒张压（mmHg）	尿肌酐（mmol/L）	尿素氮（mmol/L）	血肌酐（μmol/L）
健康对照组	50	116.30±15.47	14.28±3.12	106.35±15.68	72.55±8.36	6.86±2.34	5.59±1.98	55.58±13.50
DM组	51	110.08±17.25	12.66±2.21^a	110.42±18.75	75.72±10.23	4.93±2.83^a	5.57±1.32	52.04±10.60
HP组	51	112.49±17.99	12.86±2.29	158.88±17.62^bd	80.76±14.67^bd	5.05±2.89^b	5.87±1.67	74.93±28.27^bd
DM＋HP组	65	114.11±19.07	12.40±2.09^c	161.44±16.38^ce	79.88±13.95^c	5.46±2.90^c	6.48±2.54^ce	84.80±49.51^ce
F值	?	1.134	6.308	165.835	5.099	5.186	2.750	13.938
P值	?	0.336	<0.001	<0.001	0.002	0.002	0.044	<0.001
组别	例数	Ccr（ml/min）	TG（mmol/L）	HDL（mmol/L）	LDL（mmol/L）	HBA1C	尿酸（μmol/L）
健康对照组	50	101.72±16.13	1.36±0.63	1.08±0.25	2.44±0.68	5.21±0.58	301.82±57.13
DM组	51	95.94±23.66	1.41±0.73	1.05±0.23	2.62±0.77	9.35±1.71^a	305.54±67.57
HP组	51	87.29±28.51^b	2.12±0.98^bd	1.12±0.33	2.87±0.83^b	5.43±0.62^d	376.67±84.02^bd
DM＋HP组	65	77.10±32.66^ce	1.81±1.26^ce	1.21±0.59	2.92±1.10^c	8.65±1.74^cf	350.62±102.55^ce
F值	?	9.405	7.184	1.818	3.531	137.828	10.228
P值	?	<0.001	<0.001	0.145	0.016	<0.001	<0.001

指标	非标准化系数		标准化系数（b′）	t值	P值
指标	b	标准误	标准化系数（b′）	t值	P值
常数	1.827	0.283	?	6.456	0.000
糖尿病病程	0.026	0.004	0.488	6.565	0.000
高血压病程	0.008	0.004	0.159	2.342	0.021
左肾实质厚度	-0.027	0.009	-0.187	-2.992	0.003
左肾动脉主干血流RI	0.775	0.309	0.151	2.507	0.014
尿酸	0.001	0.000	0.123	2.072	0.041

指标	非标准化系数		标准化系数（b′）	t值	P值
指标	b	标准误	标准化系数（b′）	t值	P值
常数	1.827	0.283	?	6.456	0.000
糖尿病病程	0.026	0.004	0.488	6.565	0.000
高血压病程	0.008	0.004	0.159	2.342	0.021
左肾实质厚度	-0.027	0.009	-0.187	-2.992	0.003
左肾动脉主干血流RI	0.775	0.309	0.151	2.507	0.014
尿酸	0.001	0.000	0.123	2.072	0.041

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