Comparison of renal stiffness between diabetic patients and healthy controls using shear wave elastography
Type Ⅱ diabetes Mellitus（T2DM）is a relatively common chronic disease. The most common complication of T2DM is diabetic kidney disease (DKD). This complication has a high mortality rate, and patients have a poor prognosis and health status. Therefore, diagnosis and treatment at an early stage of D...
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| Format: | Thesis |
| Language: | English |
| Published: |
2022
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/103895/1/WANG%20ZIFAN%20-%20IR.pdf |
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| Summary: | Type Ⅱ diabetes Mellitus（T2DM）is a relatively common chronic disease. The
most common complication of T2DM is diabetic kidney disease (DKD). This
complication has a high mortality rate, and patients have a poor prognosis and
health status. Therefore, diagnosis and treatment at an early stage of DKD are
particularly important. The most common clinical screening methods for kidney
disease are computed tomography (CT), ultrasound (US), magnetic resonance
imaging (MRI), and biochemical studies. However, these methods are not
specific for early detection of DKD disease. According to diabetes guidelines,
the gold standard for chronic kidney disease (CKD) is tissue biopsy. This is an
invasive and expensive test that is rarely used in clinical practice. The prognosis
and survival of patients with DKD have become a public health issue. Early
detection of the onset of DKD and timely treatment can help patients improve
their prognosis and quality of life.
The Second Affiliated Hospital of XinXiang Medical University was used to
recruit 62 volunteers for this study. Based on their glucose metabolism, they
were divided into 3 groups: Normal Glucose Metabolism (NGM), Pre-Diabetes
Mellitus (Pre- DM) and T2DM. Each patient's medical history, baseline
demographic data, laboratory data, and ultrasound data were systematically
recorded. Renal cortical stiffness (CS) values were measured by shear wave
elastography (SWE) technique of conventional 2D ultrasound. The three sets of
data obtained in the experiment were compared to clarify differences between
and within groups. Possible early signs of DKD were detected and identified by
examining the functional curve characteristics of the participants.
With the exception of heart rate and blood pressure, all demographic data were
identical in the three groups. When laboratory data were analyzed, all laboratory
values differed between the groups, with the exception of uric acid. Blood
glucose, lipid, and blood urea nitrogen levels were significantly higher in T2DM
than in the other groups. Pre- DM and T2DM had higher LDL, creatinine, and
microalbumin than NGM. In US examinations, all ultrasound parameters were
the same in Pre- DM and T2DM.
Kidney length, kidney width, and cortical stiffness were higher in pre- DM and
T2DM than in the NGM group. The CS value of patients with abnormal glucose
metabolism was higher than that of NGM. Renal length and cortical thickness
were independently correlated with renal stiffness (r = 0.335 and r = 0.411,
respectively). Kidney thickness was an independent determinant of CS level. In
the ROC analysis, with a renal CS level of 8.5 Kpa, the specificity and sensitivity
of CS for predicting the occurrence of nephropathy were 66.7% and 66.9%,
respectively.
The CS values of subjects with impaired glucose metabolism were significantly
higher in this study based on their glucose metabolism. The performance of the
SWE as a non-invasive tool for diagnosing DKD is better than traditional
examination, and it is expected to detect and diagnose DKD early. CS Values
assessed by SWE should be used as a standard test for screening early
nephropathy in Pre-DM and newly diagnosed T2DM. According to the results, it
should be widely used in medical care. |
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