摘要
目的探讨血清成纤维细胞生长因子-21(FGF-21)、FGF-23在糖尿病肾病(DN)中的表达及其对DN的早期诊断价值。方法选取2018年7月到2019年6月期间在我院进行治疗的DN患者134例,根据尿白蛋白/肌酐(UACR)将其分为A组(<30 mg/g)、B组(30~300mg/g)、C组(>300mg/g),另选取同期在我院体检的健康志愿者100例作为对照组。检测所有研究对象的肌酐(SCr)、尿素氮(BUN)、胱抑素C(Cys C)、FGF-21、FGF-23水平,并计算肾小球滤过率(GFR)。结果对照组、A组、B组、C组的血清FGF-21、FGF-23水平逐步升高,两两比较均有统计学意义(P<0.05);经Pearson分析显示,DN患者血清FGF-21、FGF-23与SCr、BUN、Cys C呈正相关,与GFR呈负相关(P<0.05);ROC分析显示,血清FGF-21、FGF-23对DN均有较高的诊断价值,FGF-21的曲线下面积为0.838(95%CI:0.764~0.911),取235.69μg/L时,灵敏度、特异性和约登指数分别为66.70%、88.00%和0.547;FGF-23的曲线下面积为0.875(95%CI:0.807~0.943),取20.78pg/mL时,灵敏度、特异性和约登指数分别为79.20%、87.00%和0.662;二者联合诊断时灵敏度、特异性和约登指数分别为87.50%、82.00%、0.695,诊断价值可得到进一步提高。结论血清FGF-21、FGF-23在DN患者中呈异常高表达,二者的表达与肾功能密切相关,且对DN有较高的诊断价值。
Objective To investigate the expressions of serum fibroblast growth factor-21(FGF-21)and FGF-23 in diabetic nephropathy(DN)and their early diagnostic values for DN.Methods 134 patients with DN who were treated in our hospital from July,2018 to June,2019 were selected for the study,and they were divided into group A(<30 mg/g),group B(30-300 mg/g)and group C(>300 mg/g)according to urinary albumin/creatinine(UACR).Another 100 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group.The levels of creatinine(SCr),urea nitrogen(BUN),cystatin C(Cys C),FGF-21 and FGF-23 were measured,and glomerular filtration rate(GFR)was calculated.Results The serum levels of FGF-21 and FGF-23 in the control group,group A,group B and group C were all increased gradually,and there were significant differences between the two groups(P<0.05).Pearson analysis showed that serum FGF-21 and FGF-23 were positively correlated with SCr,BUN,Cys C,and they were negatively correlated with GFR(P<0.05).ROC analysis showed that serum FGF-21 and FGF-23 had high diagnostic values for DN.The area under the curve of FGF-21 was 0.838(95%CI:0.764-0.911).When the level of FGF-21 was 235.69μg/L,the sensitivity,specificity and Yoden index were 66.70%,88.00%and 0.547,respectively.The area under the curve of FGF-23 was 0.875(95%CI:0.807-0.943).When the level of FGF-23 was 20.78 pg/mL,the sensitivity,specificity and Yoden index were 79.20%,87.00%and 0.662,respectively.The sensitivity,specificity and Yoden index of combined diagnosis were 87.50%,82.00%and 0.695,respectively,indicating an improved diagnostic value.Conclusion Serum levels of FGF-2 and FGF-23 are abnormally high in patients with DN.The expressions of FGF-21 and FGF-23 are closely related to renal function,and they have high diagnostic value for DN.
作者
黄丽君
占志平
张琳静
熊小琴
童俊
童惠
HUANG Lijun;ZHAN Zhiping;ZHANG Linjing;XIONG Xiaoqin;TONG Jun;TONG Hui(Department of Laboratory of Tongji Huangzhou Hospital Affiliated to Huazhong University of Science and Technology,Department of Laboratory of Huangzhou District People′s Hospital, Huanggang 438000,China)
出处
《标记免疫分析与临床》
CAS
2020年第4期598-602,共5页
Labeled Immunoassays and Clinical Medicine
基金
2016年湖北省自然科学基金项目(编号:2016CFB122)。
