摘要
目的分析脂蛋白α[LP(α)]、血清胱抑素-C(Cys-C)和尿酸(UA)检验在早期糖尿病肾病(DN)诊断中的应用价值。方法回顾性分析2020年1月至2021年8月在葫芦岛市中心医院确诊的2型糖尿病(T2DM)患者150例,根据尿白蛋白肌酐比值(UACR)分组,即正常白蛋白尿(NA)组50例(UACR 0~3 mg/mmol),微量白蛋白尿(MA)组51例(UACR 3~29 mg/mmol)和临床白蛋白尿(CA)组49例(UACR>30 mg/mmol),检验并比较3组一般临床资料、相关临床指标及血清LP(α)、Cys-C和UA水平,采用Pearson直线相关及Logistic回归分析各指标与DN的关系,采用受试者工作特征(ROC)曲线评估各指标对DN的诊断价值。结果3组收缩压、舒张压差异有统计学意义(P<0.05);UACR、血肌酐(SCr)、肾小球滤过率(eGFR)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、Cys-C、UA、LP(α)差异有统计学意义(P<0.05)。与NA组相比,MA组的LP(α)的水平升高最明显,差异有统计学意义(P<0.05)。Pearson相关性分析显示,血清Cys-C、UA、LP(α)与UACR、SCr均呈正相关,与eGFR呈负相关;Logistic回归分析表明,Cys-C和LP(α)是早期DN的独立危险因素(P<0.05);ROC曲线分析结果显示,血清Cys-C和LP(α)对早期DN有较高的的诊断价值。结论血清LP(α)、Cys-C和UA均可反映糖尿病患者肾损伤的程度,其中LP(α)和Cys-C是早期DN的独立危险因子,三者联合诊断准确度最高,对早期预测DN发生具有较高的诊断效能。
Objective To analyze the diagnostic value of serum lipoprotein(α)[LP(α)],cystatin-C(Cys-C)and uric acid(UA)on early diabetic nephropathy(DN).Methods In this retrospective analysis,150 diagnosed type 2 diabetes mellitus(T2DM)patients admitted to Huludao Central Hospital from January 2020 to August 2021 were enrolled,according to urinary albumin/creatinine ratio(UACR),those patients were assigned into normal albuminuria(NA)group(n=50,UACR:0~3 mg/mmol),microalbuminuria(MA)group(n=51,UACR:3~29 mg/mmol),clinical albuminuria(CA)group(n=49,UACR>30 mg/mmol).The general clinical data,correlated clinical indexes,Serum LP(α),Cys-C,UA level were detected and compared among three groups.Pearson's correlation and Logistic regression analysis were used to analyze the correlation between each index and DN;receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of each index for DN.Results Among three groups,difference was statistically significant in the systolic blood pressure(SBP)and diastolic blood pressure(DBP)(P<0.05);there were significant differences in the serum creatine(SCr),estimated glomerular filtration rate(eGFR),fasting plasma glucose(FPG),glycosylated hemoglobin A1c(HbA1c),Cys-C,UA,LP(α)(P<0.05).LP(α)in MA group significantly increased when compared with NA group,with statistically significant difference(P<0.05).Pearson's correlation showed that serum Cys-C,UA,LP(α)were positively correlated with UACR and SCr,while negatively correlated with eGFR.Logistic regression analysis showed that the independent risk factors for early DN included Cys-C and LP(α).The results of ROC curve analysis showed that serum Cys-C and LP(α)had high diagnostic value for early DN.Conclusion Different degrees of renal damage in T2DM patients were reflected by Serum LP(α),Cys-C and UA,of which LP(α)and Cys-C being independent risk factors for early DN.The highest accuracy emerges in the combined of the three,with high diagnostic efficacy of prediction for early DN.
作者
高士欣
宋冰
施克新
Gao Shixin;Song Bing;Shi Kexin(Graduate School of Jinzhou Medical University, Huludao Central Hospital, Huludao 125000, China;Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China;Department of Endocrine, Huludao Central Hospital, Huludao 125000, China)
出处
《临床荟萃》
CAS
2022年第3期248-252,共5页
Clinical Focus
关键词
糖尿病肾病
脂蛋白Α
胱抑素-C
尿酸
2型糖尿病
尿白蛋白肌酐比值
diabetic nephropathies
lipoproteinα
cystatin-C
uric acid
type 2 diabetes mellitus
urinary albumin/creatinine ratio
作者简介
通信作者:宋冰,Email:13634965277@163.com。
