摘要
目的评价血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)早期诊断2型糖尿病肾病(DKD)的临床价值。方法实验纳入2型糖尿病(T2DM)病人316例,根据尿白蛋白/肌酐比值(ACR)将病人分为正常白蛋白尿组(ACR<30 mg/g)149例、微量白蛋白尿组(30 mg/g≤ACR≤300 mg/g)99例、大量白蛋白尿组(ACR>300 mg/g)68例。以270例健康体检者为对照组。测定实验对象的血清NGAL(sNGAL)、血清胱抑素C(CysC)、血清葡萄糖(Glu)、糖化血红蛋白(HbA1c)和尿液白蛋白/肌酐比值(ACR)。使用SPSS 19.0和Med Cal 12.7统计软件进行统计学分析。用受试者工作特征曲线(ROC)的曲线下面积(AUC)、灵敏度和特异性表示诊断性能,以最佳优登指数获取判断值。结果正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组sNGAL水平高于对照组,差异有统计学意义(P<0.05);且随着ACR的升高,sNGAL逐渐升高;微量白蛋白尿组、大量白蛋白尿组CysC水平高于对照组,eGFR水平低于对照组,差异均有统计学意义(P<0.05);正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组HbA1c、Glu水平均高于对照组,差异有统计学意义(P<0.05),但在三组间差异无统计学意义(P>0.05)。sNGAL与CysC(r=0.639,P<0.001)、ACR(r=0.445,P<0.001)和HbA1c(r=0.160,P=0.004)呈正相关,与eGFR(r=-0.639,P<0.001)呈负相关。以150.1μg/L为判断值,sNGAL诊断DKD的灵敏度和特异性分别为65.3%和86.6%,AUC=0.792。结论sNGAL是一个早期诊断DKD的生物标记物。
Objective To evaluate the diagnostic performance of serum neutrophil gelatinase-associated lipocalin(NGAL)in the early diagnosis of type 2 diabetic kidney disease(DKD).Methods A total of 316 patients with type 2 diabetes mellitus(T2 DM)were enrolled.Patients were divided into three groups according to urinary albumin/creatinine ratio(ACR):ACR<30 mg/g for normal albuminuria group,149 patients;30 mg/g≤ACR≤300 mg/g for the microalbuminuria group,99 cases;ACR>300 mg/g for the large albuminuria group,68 cases.A total of 270 healthy subjects were used as normal controls.Serum NGAL(sNGAL),serum cystatin C(CysC),serum glucose(Glu),glycated hemoglobin(HbA1 c),and urinary albumin/creatinine ratio(ACR)were measured.Statistical analysis was performed on the results of the assay using SPSS 19.0 and Med Cal 12.7 statistical software.The area under curve(AUC)of receiver operating characteristic curve and sensitivity and specificity were used for expressing diagnostic performance.Results The levels of sNGAL in normal albuminuria group,microalbuminuria group,and large albuminuria group were significantly higher than those in control group(P<0.05).As increase of ACR,sNGAL gradually increased.The levels of CysC in microalbuminuria group and large albuminuria group were significantly higher than those in control group(P<0.05),and eGFR were significantly lower than those in control group(P<0.05).The levels of HbA1 c and Glu in normal albuminuria group,microalbuminuria group,and large albuminuria group were significantly higher than those in control group(P<0.05),but there were no significantly difference between three groups in patients(P>0.05).sNGAL was positively correlated with CysC(r=0.639,P<0.001),ACR(r=0.445,P<0.001)and HbAlc(r=0.160,P=0.004),and eGFR(r=-0.639,P<0.001)was negatively correlated.Using 150.1μg/L as the cutoff,the sensitivity and specificity of sNGAL for diagnosis of DKD were 65.3%and86.6%,respectively,and AUC=0.792.Conclusion sNGAL could be used as a biomarker for the early diagnosis of DKD.
作者
刘运双
张彬
张亚梅
罗立梅
邓蔷
LIU Yun-shuang;ZHANG Bin;ZHANG Ya-mei;LUO Li-mei;DENG Qiang(Department of Clinical Laboratory,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)
出处
《热带医学杂志》
CAS
2020年第1期97-101,共5页
Journal of Tropical Medicine
