胰腺再生蛋白水平在糖尿病肾病人群中显著升高  

Serum level of pancreatic regenerating protein elevates dramatically in diabetic kidney disease

作　　者：李玲[1] 杨家悦[1] 祝祥云 

机构地区：[1]东南大学附属中大医院内分泌科,南京210009

出　　处：《中华糖尿病杂志》2016年第8期468-472,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金（81270010、81570739）;江苏省六大人才高峰资助项目（1190000020）

摘　　要：目的探讨2型糖尿病（T2DM）患者血清胰腺再生蛋白（Reg）水平对预测糖尿病肾病（DKD）的意义。方法选取2011年2月至2012年2月东南大学附属中大医院健康体检者、门诊及住院患者，根据诊断和排除标准总共纳入138例参与者，将其分为4组：健康对照组50例（A组，男26，女24），平均年龄（54＋9）岁；初发T2DM组36例（B组，男2l，女15），平均年龄（56±8）岁；长病程T2DM无DKD组25例（C组，男15，女10），平均年龄（55±8）岁；长病程T2DM有DKD组27例（D组，男13，女14），平均年龄（55±11）岁。采用酶联免疫吸附法（ELISA）i）NJ]定受试者清晨空腹状态下的血清Reg水平。利用单因素方差分析进行多组间比较，Spearman和Pearson相关分析检测血清Reg水平与临床参数的关系，绘制受试者工作特征（ROC）曲线以评价血清Reg的诊断效能。结果D组Reg水平为（57±21）μg／L，明显高于A、B和C组[分别为（14±3）、（18±7）、（24±7）μg／L，t=14．41、11．29、6．78，均P〈0．01]。Reg水平与收缩压、空腹血糖、餐后2h血糖、糖化血红蛋白正相关（r=0．136、0．215、0．198、0．382，P〈0．01），与肾小球滤过率（GFR）、肌酐清降率（Ccr）呈负相关（r=-0．533、-0．421，P〈0．01）。Reg诊断DKD的ROC曲线下面积为0．902[95％Cl（0．737—0．959）]，最佳切点为32μg／L，其灵敏度为69％，特异度93％，阳性似然比2．09，阴性似然比0．73。结论血清Reg水平在DKD人群中显著升高，提示Reg有可能成为早期诊断DKD的辅助性生物标志物。Objective To estimate the diagnostic value of pancreatic regenerating protein（Reg） in type 2 diabetic （T2DM） patients with diabetic kidney disease （DKD）. Methods According to diagnostic criteria and exclusion criteria, a total of 138 subjects admitted to in Zhongda Hospital Southeast University from February 2011 to February 2012 were included for the study. They were divided into four groups： 50 healthy patients （group A, 26 males and 24 females, mean age （54± 9） yrs）, 36 newly diagnosed T2DM patients （group B, 21 males and 15 females, mean age（56±8） yrs）, 25 long-term T2DM patients （group C, 15 males and 10 females, mean age（55±8） yrs）, 27 DKD patients（group D, 13 males and 14 females, mean age （55 ± 11） yrs）. Enzyme linked immunosorbent assay was used to determine the fasting serum Reg levels. Differences between groups were determined by one-way analysis of variance. Correlations of Reg and clinical parameters were performed using Spearman and Pearson correlation coefficient and the sensitivities of Reg were evaluated by receiver operating characteristic （ROC） curve in diagnosis of diabetic nephropathy. Results The level of serum Reg in group D （57±21）μg/L was significantly higher than that in the group A （ 14±3 ）μg/L, B （18±7）μg/L or C （24±7）μg/L（t= 14.41, 11.29, 6.78, all P〈0.01 ）. Reg level was positively correlated with systolic pressure, fasting plasma glucose, 2-hour postprandial blood glucose and glyeosylated hemoglobin A1c （r=0.136, 0.215, 0.198, 0.382, all P〈0.01 ）and negatively with glomerular filtration rate （GFR） and creatinine clearance rate （r=- 0.533,- 0.421, all P〈0.01）. The area under curve of Reg diagnosing DKD was 0.902 （95% （0.737-0.959））, and the optimum cut-off point was 32μg/L, with sensitivity, specificity, positive likelihood ratio and negative likelihood ratio （69%, 93%, 2.09, 0.73, respectively）. Conclusion The level of Reg up-regulated in type 2 diabetic patients, especi

关 键 词：糖尿病 2型 糖尿病肾病 胰腺再生蛋白 

分 类 号：R587.2[医药卫生—内分泌]