摘要
目的探讨糖尿病肾病(DN)患者血清肌肉生长抑制素(myostatin)水平及其与血管钙化的关系。方法选取2019年5月至2021年5月该院收治的120例DN患者作为病例组,根据Mogenson分期标准及相关检查进一步分为病例A组(DNⅠ/Ⅱ期)、病例B组(DNⅢ期)、病例C组(DNⅣ期)、病例D组(DNⅤ期),另选取同期于该院体检的健康者30例作为对照组。采用彩超检查颈部血管钙化情况,酶联免疫吸附试验(ELISA)检测血清myostatin水平。绘制受试者工作特征(ROC)曲线评估血清myostatin水平对DN患者出现血管钙化的预测价值。结果病例A组与对照组血清myostatin水平比较,差异无统计学意义(P>0.05),而病例B、C、D组血清myostatin水平低于对照组,差异有统计学意义(P<0.05)。病例A、B、C、D组颈总动脉钙化率高于对照组,病例D组颈总动脉钙化率高于病例A、B组,差异均有统计学意义(P<0.05)。DN血管钙化患者钙磷乘积、CRP水平高于非血管钙化患者,而myostatin水平低于非血管钙化患者,差异均有统计学意义(P<0.05)。相关性分析显示,myostatin与钙磷乘积、CRP呈负相关(r=-0.293、-0.361,P=0.015、0.019)。血清myostatin、CRP、钙磷乘积预测DN患者出现血管钙化的ROC曲线下面积(AUC)为0.734、0.683、0.698。多因素Logistic回归分析显示,高水平myostatin是DN患者发生血管钙化保护因素,高CRP、高钙磷乘积是DN患者发生血管钙化危险因素(P<0.05)。结论DN患者血清myostatin水平升高,且合并血管钙化的DN患者血清myostatin水平更高,血清myostatin对DN患者血管钙化具有一定的预测价值,有望作为DN患者血管钙化早期生物标志物。
Objective To explore the correlation between serum myostatin level and vascular calcification in patients with diabetic nephropathy(DN).Methods A total of 120 patients with DN treated in this hospital from May 2019 to May 2021 were selected as case group.According to Mogenson staging criteria and related examinations,the case group was further divided into case A group(stageⅠ/Ⅱ),case B group(stageⅢ),case C group(stageⅣ),and case D group(stageⅤ).Another 30 people who underwent physical examination in this hospital during the same period were selected as control group.Cervical vascular calcification was examined by color Doppler ultrasound,and serum myostatin level was detected by enzyme-linked immunosorbent assay(ELISA).Receiver operating characteristic(ROC)curves were drawn to evaluate the predictive value of serum myostatin for vascular calcification in DN patients.Results There was no significant difference in serum myostatin between case A group and control group(P>0.05),while the serum myostatin of case B,C,and D groups was lower compared with the control group,the difference was statistically significant(P<0.05).The carotid artery calcification rate of case A,B,C,and D groups was higher than that of the control group,and the carotid artery calcification rate of the case D group was higher than that of the case A and B groups,with statistical significance(P<0.05).The Ca×Pand CRP level in DN patients with vascular calcification were higher than those in non-vascular calcification,while the myostatin level was lower than that in non-vascular calcification(P<0.05).Correlation analysis showed that myostatin negatively correlated with Ca×Pand CRP level(r=-0.293,-0.361,P=0.015,0.019).The area under the ROC curve(AUC)of serum myostatin,CRP level and Ca×Ppredicting the vascular calcification in DN were 0.734,0.683 and 0.698.Multivariate Logistic regression analysis showed that high level of myostatin was a protective factor for vascular calcification in DN patients,while high CRP and high calcium-phosphorus product were risk factors for vascular calcification in DN patients(P<0.05).Conclusion Serum myostatin level is elevated in patients with DN,and the serum myostatin level in DN patients with vascular calcification is higher.Serum myostatin has a certain predictive value for vascular calcification in patients with DN,and is expected to be a biomarker for early vascular calcification in patients with DN.
作者
马懿
曾蜀春
MA Yi;ZENG Shuchun(Department of Nephrology,Sichuan Mianyang 404 Hospital,Mianyang,Sichuan 621053,China)
出处
《国际检验医学杂志》
CAS
2022年第16期2020-2023,共4页
International Journal of Laboratory Medicine
