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Background Normoalbuminuric diabetic kidney disease (NADKD) is a newly defined DKD, the clinical features and pathogenesis for which are still being understood. This study aimed to investigate the features and risk factors for NADKD in patients with type 2 diabetes mellitus (T2DM). Methods A retrospective cross-sectional study was conducted. The related clinical and laboratory data of patients with T2DM hospitalized between August 2012 and January 2020 were collected for statistical analysis. We classified the patients with T2DM into four groups on the basis of the presence or absence of albuminuria and reduced estimated glomerular filtration rate (eGFR). Analysis of variance, the Kruskal–Wallis test, and the chi-square test were used to compare the groups. Binary logistic regression analyses with a forward stepwise method were performed to explore the risk factors for renal dysfunction in hospitalized patients with normoalbuminuric T2DM. Results Among the 1620 patients evaluated, 500 (30.9%) had DKD, of which 9% had NADKD. The prevalence of stroke, cardiovascular events, carotid plaque, and peripheral arterial disease in NADKD was significantly higher than in a non-DKD control group (normoalbuminuric T2DM patients with eGFR of ≥60 ml/min/1.73 m2). Regression analyses revealed that three significant independent factors were associated with NADKD: age (OR = 1.089, confidence interval [CI] 95% [1.055–1.123], p p = 0.011), and glycated hemoglobin (HbA1c; OR = 0.839, CI 95% [0.716–0.983], p = 0.03). Conclusions NADKD is mainly associated with macrovascular rather than microvascular complications. NADKD is more common in patients with normoalbuminuric T2DM with older age, previous use of RASIs, and good glycemic control.

To compare the flow-mediated dilatation (FMD) among the newly diagnosed impaired glucose tolerance (IGT), type 2 diabetes mellitus (T2DM), and the normal controls (NC) and to analyze relevant factors under different glucose levels.The study included IGT (n=34), DM1 (n=52), DM2 (n=33) and NC (n=25). Levels of fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG), fasting insulin (FINS), 2-hour postprandial insulin (PINS), triglyceride (TG), total cholesterol (TC), and hemoglobin A1C (HbA1C) were determined in all participants. High resolution ultrasound examining FMD was performed to measure vascular endothelial function subsequently.There was statistically significant difference between IGT, DM, HG and NC group in FMD (P=0.008). Partial correlation analysis found that a significant negative correlation existed between FMD and homeostasis model assessment-index (HOMA-IRI), difference of plasma glucose (DPG), FPG and PPG (P0.01), and a negative correlation between FMD and HbA1C (P0.05). Setting FMD as dependent variable to conduct multiple linear stepwise regression, in IGT group it was the waist/hip ratio (WHR) and HOMA-IRI that entered the regression equation; in DM1 group it was HOMA-IRI, PPG and DPG that entered the regression equation; in DM2 group it was FPG and HOMA-beta that entered the regression equation.There exists a flow-mediated vasodilatation dysfunction in patients of newly diagnosed IGT and T2DM. Effect of relevant factors on FMD differs with different glucose levels.

To explore the diagnostic value of procalcitonin (PCT) quantification in ventilator associated pneumonia (VAP).Sixty-one patients on ventilators were divided into VAP group and non-VAP group depending on whether the patients developed VAP in 7 days or not. The PCT levels were determined with the method of semi-solid phase immunoassay before and 7 days after instillation of mechanical ventilation in these patients. The PCT levels were graded into four categories, i.e.0.5 microg/L, 0.5-2.0 microg/L, 2.0-10.0 microg/L andor =10.0 microg/L. At the same time, C reactive protein (CRP) content and white blood cell (WBC) count were also determined.Before mechanical ventilation, the CRP and WBC count showed no obvious difference in both groups (all P0.05). The CRP content and WBC count were found to be obviously elevated in VAP group compared with non VAP group (all P=0.000). The diagnostic sensitivity of CRP and WBC count for VAP were 73.5% (25/34 cases) and 82.3% (28/34 cases) respectively, their specificity was 48.1% (13/27 cases) and 55.5% (15/27 cases), respectively, and their positive prediction rates were 64. 1% (25/39 cases) and 70.0% (28/40 cases), respectively, and their negative prediction rates were 59.1% (13/22 cases) and 71.4% (15/21 cases), respectively. If serum PCTor =0.5 microg/L was regarded as the cutoff value, the PCT positive percentage did not show difference between VAP group and non VAP group before mechanical ventilation (P0.05). However, after VAP, the PCT positive percentage of VAP group was much higher than that of non VAP group. The sensitivity of serum PCT determination for the diagnosis of VAP was 85.3% (29/34 cases), with specificity rate 74.1% (20/27 cases), positive prediction rate 80.5% (29/36 cases), and negative prediction rate 80.0% (20/25 cases).The value of serum PCT has high sensitivity rate in the diagnosis of VAP, so that timely surveillance of serum PCT change is helpful for the diagnosis of VAP in the early stage.