摘要
目的探讨血清4-羟基壬烯醛(4-HNE)、人软骨糖蛋白-39(YKL-40)、肾损伤分子-1(KIM-1)在糖尿病肾病(DN)早期肾损伤中的临床价值,并分析4-HNE、YKL-40、KIM-1与肾损伤指标、血糖水平、血脂水平的相关性。方法选取2019年1~7月萍乡市人民医院内分泌科收治的89例2型糖尿病(T2DM)患者,根据24 h尿蛋白排泄率(UAER)结果分为正常蛋白尿组/单纯糖尿病组(NA组)、微量蛋白尿组(MI组)和大量蛋白尿组(MA组)。另选萍乡市人民医院体检科的53例健康体检者作为健康对照组(NC组)。采用酶联免疫吸附(ELISA)法检测各组血清中的4-HNE、YKL-40、KIM-1浓度。结果MA组的血清4-HNE、YKL-40、KIM-1高于MI组,差异有统计学意义(P<0.05);MI组的血清4-HNE、YKL-40、KIM-1高于NA组,差异有统计学意义(P<0.05);NA、MI、MA组的血清4-HNE、YKL-40、KIM-1均高于NC组,差异有统计学意义(P<0.05)。NA、MI、MA组患者的空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血清肌酐(SCr)、血尿素氮(BUN)、UAER均高于NC组,差异有统计学意义(P<0.05);相关性分析显示,SCr、尿微量蛋白(UmALB)、UAER、FPG、HbA1c与4-HNE、YKL-40、KIM-1成正相关(r=0.428、0.349、0.390,0.501、0.446、0.491,0.478、0.409、0.461,0.414、0.502、0.497,0.584、0.558、0.607;P<0.05);BUN与4-HNE、YKL-40成正相关(r=0.223、0.176,P<0.05);低密度脂蛋白(LDL)与4-HNE、YKL-40、KIM-1成负相关(r=-0.169、-0.289、-0.247,P<0.05)。结论血清4-HNE、YKL-40、KIM-1可作为DN早期诊断的敏感指标,有望为临床中DN的诊断提供依据;血清4-HNE、YKL-40、KIM-1与肾损伤指标、血糖水平成正相关。
Objective To investigate the clinical value of serum 4-hydroxynonenal(4-HNE),serum human chondroglycoprotein-39(YKL-40)and kidney injury molecule 1(KIM-1)in early renal injury of diabetic nephropathy(DN),and to analyze the correlation of 4-HNE,YKL-40 and KIM-1 with renal injury index,blood glucose and lipid level.Methods A total of 89 patients with type 2 diabetes mellitus(T2DM)hospitalized in the Department of Endocrinology of Pingxiang People′s Hospital from January to July in 2019 were selected,and the patients were divided into normal albuminuria group or only diabetes group(group NA),microalbuminuria group(group MI)and macro albuminuria group(group MA)according to the 24 h urinary protein excretion rate(UAER).In addition,53 healthy patients in the Physical Examination Department of Pingxiang People′s Hospital were selected as the normal control group(NC).Serum concentrations of 4-HNE,YKL-40 and KIM-1 were determined by enzyme linked immunosorbent assay(ELISA).Results The serum 4-HNE,YKL-40 and KIM-1 in the group MA were higher than those in the group MI,with statistically significant differences(P<0.05).The serum 4-HNE,YKL-40 and KIM-1 in the group MI were higher than those in the group NA,with statistically significant difference(P<0.05).The serum 4-HNE,YKL-40 and KIM-1 in the groups NA,MI and MA were higher than those in the group NC,and the differences were statistically significant(P<0.05).The fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),serum creatinine(SCr),blood urea nitrogen(BUN),UAER indexes in groups NA,MI MA were higher than those in group NC,with statistically significant differences(P<0.05).Correlation analysis showed that SCR,BUN,Urinary microprotein(UmALB),UAER,FPG and HbA1c were positively correlated with 4-HNE,YKL-40 and KIM-1(r=0.428,0.349,0.390;0.501,0.446,0.491;0.478,0.409,0.461;0.414,0.502,0.497;0.584,0.558,0.607;P<0.05).BUN was positively correlated with 4-HNE and YKL-40(r=0.223,0.176;P<0.05).Low density lipoprotein(LDL)was negatively correlated with 4-HNE,YKL-40 and KIM-1(r=-0.169,-0.289,-0.247;P<0.05).Conclusion 4-HNE,YKL-40 and KIM-1 can be used as a sensitive indicator for the early diagnosis of DN,and is expected to provide a basis for the diagnosis of DN in clinical practice.Serum 4-HNE,YKL-40 and KIM-1 are positively correlated with renal injury index and blood glucose level.
作者
余世纪
苏晓清
王桂良
吴素珍
谢勇丽
YU Shi-ji;SU Xiao-qing;WANG Gui-liang;WU Su-zhen;XIE Yong-li(Gannan Medical University,Jiangxi Province,Ganzhou341000,China;Department of Endocrinology,Pingxiang People′s Hospital Affiliated to Gannan Medical University,Jiangxi Province,Pingxiang 337000,China;Department of Gastroenterology,Pingxiang People′s Hospital Affiliated to Gannan Medical University,Jiangxi Province,Pingxiang 337000,China;Basic Medical College of Gannan Medical University,Jiangxi Province,Ganzhou 341000,China)
出处
《中国当代医药》
2020年第12期59-63,共5页
China Modern Medicine
