Value of ultrasound micro-flow imaging combined with serum inflammatory factors in the diagnosis of diabetic kidney disease

Abstract

Objective To investigate the value of ultrasound micro-flow imaging (MFI) combined with serum inflammatory factors in the early diagnosis of diabetic kidney disease (DKD). Methods A total of 92 patients with DKD who were admitted to The Affiliated Hospital of Qingdao University from June 1, 2022 to June 30, 2023 were enrolled as DKD group, and 64 patients with type 2 diabetes mellitus (T2DM) who were admitted to our hospital during the same period of time were enrolled as T2DM group. Related data were collected for the two groups, including clinical indicators, ultrasound blood flow parameters, and serum inflammatory factors. Ultrasound blood flow parameters included MFI-value, left renal interlobar artery resistance index (RI1), right renal interlobar artery resistance index (RI2), left renal interlobar arterial peak velocity (PSV1), and right renal interlobar arterial peak velocity (PSV2). The Spearman method was used to investigate the correlation of MFI-value with clinical indicators and serum inflammatory factors; the forward conditional approach in binary logistic regression was used to analyze the impact of DKD; the receiver operating characteristic (ROC) curve was used to analyze the value of MFI-value and serum inflammatory factors in predicting DKD. Results Compared with the DKD group, the T2DM group had significantly lower RI1 and serum levels of C-reactive protein, interleukin-6 (IL-6), and interleukin-18 (Z=-6.73--3.20,P<0.05) and significantly higher levels of MFI-value and PSV2 (Z=-9.53,-2.67,P<0.05). MFI-value was positively correlated with hemoglobin (HB) and estimated glomerular filtration rate (eGFR) and was negatively correlated with serum creatinine (Scr) and urinary albumin-to-creatinine ratio (UACR); serum IL-6 was positively correlated with Scr and UACR and was negatively correlated with HB and eGFR. The binary logistic regression analysis showed that MFI-value (OR=0.596,95%CI=0.473-0.751,P<0.05) and serum IL-6 (OR=2.184,95%CI=1.243-3.839,P<0.05) showed a certain effect in the diagnosis of DKD. MFI-value and serum IL-6 alone had an area under the ROC curve (AUC) of 0.949 (95%CI=0.909-0.989) and 0.830 (95%CI=0.767-0.892), respectively, in the diagnosis of DKD in T2DM patients, and the combination of MFI-value and serum IL-6 had an AUC of 0.970 (95%CI=0.942-0.999). Conclusion MFI-value combined with the serum level of IL-6 can improve the early clinical diagnostic rate of DKD, which may provide a reference for the monitoring and prevention of DKD.

Keywords

• diabetic nephropathies|ultrasonography|hemodynamics|interleukin-16|interleukin-18|early diagnosis