相关生物标志物在糖尿病肾病早期诊断的临床意义  

The value of SDF-1,NGAL and copeptin levels in the early diagnosis of diabetic nephropathy

作　　者：罗萍[1] 毛继明[1] 汪浩[1] 颜雪莹 王婷[1] 

机构地区：[1]湖北省武汉市汉口医院检验科,430012

出　　处：《检验医学与临床》2017年第14期2082-2085,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨血清基质细胞衍生因子-1(SDF-1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)、和肽素(Copeptin)对糖尿病肾病(DN)患者肾功能损伤的诊断及预后评价。方法选取2014年6月至2016年6月该院158例DN患者,根据尿蛋白/肌酐比值(ACR)将患者分为:正常清蛋白尿组(NA组,n=52),微量清蛋白尿组(MA组,n=48),临床清蛋白尿组(CP组,n=58),另选取40例健康体检者作为健康对照组。应用ELISA法检测各组血清SDF-1、NGAL、Copeptin水平。结果 NA组、MA组、CP组空腹葡萄糖(FPG)、体质量指数(BMI)、糖化血红蛋白(HbAlc)、胰岛抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)、低密度蛋白(LDL-C)、血尿酸、胱抑素C(Cys C)、尿清蛋白排泄率(UAER)、SDF-1、NGAL、Copeptin水平高于健康对照组(P<0.05),而高密度脂蛋白(HDL-C)低于健康对照组(P<0.05)。MA组、CP组FPG、BMI、HbAlc、HOMA-IR、血尿酸、Cys C、UAER、SDF-1、NGAL、Copeptin水平高于NA组(P<0.05),CP组Cys C、UAER、SDF-1、NGAL、Copeptin水平高于MA组(P<0.05)。经Spearman单因素分析,血清SDF-1与FPG、HOMA-IR、Cys C、UAER呈正相关(P<0.05),NGAL与HOMA-IR、Cys C、UAE呈正相关(P<0.05),Copeptin与Cys C、UAER呈正相关(P<0.05)。经Logistic多因素分析,HOMA-IR、Cys C、SDF-1、NGAL、Copeptin是DN发生的独立危险因素。受试者工作特征(ROC)曲线分析,血清SDF-1、NGAL、Copeptin诊断DN的曲线下面积(AUC)分别为0.842、0.812、0.805。结论血清SDF-1、NGAL、Copeptin水平与早期DN发生密切相关,可作为DN早期诊断指标。Objective To investigate the diagnostic value of serum stromal cell-derived factor-1（SDF-1）,neutrophil gelatinase-related apolipoprotein（NGAL）,and peptide peptide（Copeptin） in patients with diabetic nephropathy（DN）.Methods 158 patients with DN were enrolled from June 2014 to June 2016.The patients were divided into normal albuminuria group（NA group,n=52） and microalbuminuria group（MA group,n=48）,clinical albuminuria group（CP group,n=58） accorded to urinary protein/creatinine ratio（ACR）,40 healthy subjects were selected as the control group,the clinical data of each group were recorded,Serum SDF-1,NGAL and Copeptin were detected in all groups.Results The levels of fasting glucose（FPG）,body mass index（BMI）,glycosylated hemoglobin（HbA1c）,insulin resistance index（HOMA-IR）,triglyceride（TG）,total cholesterol（TC） The serum levels of SDF-1,NGAL and Copeptin were higher than those of the control group（P〈0.05）,while the levels of HDL-C,Cys C,UAER,HDL-C were lower than those of the control group（P〈0.05）,while HDL-C was lower than the control group（P〈0.05）.UAER,SDF-1,NGAL and Copeptin levels in the MA group and CP group were significantly higher than those in the NA group（P〈0.05）.The levels of Cys C,UAER,SDF-1,NGAL and Copeptin levels were higher than those in MA group（P〈0.05）.SDF-1 was positively correlated with FPG,HOMA-IR,Cys C and UAER（P〈0.05）,NGAL was positively correlated with HOMA-IR,Cys C and UAE（P〈0.05）,Copeptin was positively correlated with Cys C and UAER with Spearman single factor analysis（P〈0.05）.The area under the ROC curve of serum SDF-1,NGAL and Copeptin were 0.842,0.812 and 0.805,respectively.Conclusion Serum levels of SDF-1,NGAL and Copeptin are closely related to the occurrence of early DN and can be used as an early diagnostic indicator of DN.

关 键 词：基质细胞衍生因子-1 中性粒细胞明胶酶相关载脂蛋白 和肽素 糖尿病肾病 

分 类 号：R135.1[医药卫生—劳动卫生]