血清NGAL在早期2型糖尿病肾脏疾病诊断中的作用  

The diagnosis value of serum NGAL in early type 2 diabetic kidney disease

作　　者：马续祥 陈卫东 纵晓英[1] 王道洋[1] 黄玉萍[1] 李莹[1] MA Xu-xiang;CHEN Wei-dong;ZONG Xiao-ying;WANG Dao-yang;HUANG Yu-ping;LI Ying(Department of Nephropathy,The Second Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233040;Department of Nephropathy,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第二附属医院肾内科,安徽蚌埠233040 [2]蚌埠医学院第一附属医院肾内科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2018年第5期595-598,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨2型糖尿病(T2DM)病人血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平及其与早期糖尿病肾脏疾病(DKD)之间的关系。方法:选择T2DM病人共95例,并根据尿白蛋白排泄率(UAER)分为3组,其中正常白蛋白尿组(NA组)(UAER<20μg/min)25例,微量白蛋白尿组(MA组)(20μg/min≤UAER<200μg/min)30例,临床蛋白尿组(CA组)(UAER≥200μg/min)40例,选取非DKD并排除其他肾脏病的正常对照39名。应用ELISA法检测血清中NGAL水平,对不同分组之间及与正常对照相关检测结果进行比较,并分析NGAL与sCr、BUN、CysC及e GFR之间的相关性,并通过ROC曲线,评估NGAL对早期DKD诊断的敏感度。结果:NA、MA、CA组NGAL水平均较对照组升高(P<0.01),其中CA组最高达(185.65±61.76)ng/m L。Spearman分析显示,NGAL与BUN、sCr、CysC呈正相关关系(rs值分别为0.395、0.408和0.257,P<0.05~P<0.01);NGAL与e GFR、Alb呈负相关关系(rs值分别为-0.328和-0.430,P<0.01);以UAER>20μg/min为界,MA与CA组病人血清NGAL与CysC ROC曲线下面积分别为0.675和0.789。结论:早期DKD病人血清NGAL与BUN、sCr、CysC及e GFR存在相关性,NGAL可作为诊断早期DKD的敏感指标。Objective： To explore the correlation between the serum level of neutrophil gelationase associated lipocalin（ NGAL） in type 2 diabetes mellitus（ T2 DM） and early diabetic kidney disease（ DKD）. Methods： A total of 95 patients with T2 DM were divided into the normal albuminuria group（ NA group,UAER 〈20 μg/min,n = 25）,microalbuminuria group（ MA group,20 μg/min≤UAER 〈200 μg/min,n = 30）,and clinical albuminuria group（ CA group,UAER≥200 μg/min,n = 40）,and 39 healthy volunteers were set as normal control group. The serum NGAL levels in all cases were measured by ELISA,and the correlations between NGAL and sCr,BUN,CysC and e GFR were analyzed. The sensitivity of serum NGAL in early diagnosis of DKD was evaluated using receiver operating characteristic（ ROC） curve. Results： The levels of serum NGAL in NA,MA,and CA groups increased compared with control group（ P〈0. 01）,which in CA group was the highest [（ 185. 65 ± 61. 76） ng/m L]. Spearman analysis showed that the serum NGAL level was positively correlated with the levels of BUN,sCr and CysC（ rs= 0. 395,0. 408 and 0. 257,respectively,P〈0. 05 to P〈0. 01）,and the serum NGAL level was negatively correlated with the levels of e GFR and Alb,respectively（ rs=-0. 328 and-0. 430,respectively,P〈0. 01）. The UAER〉20 μg/min was set as critical point,the area of serum NGAL and CysC under ROC curve in MA group and CA group were 0. 675 and 0. 789,respectively. Conclusions： The serum NGAL level is related to the levels of BUN,sCr,CysC and e GFR in early DKD patients,and the NGAL may be a sensitive indicator in the early diagnosis of DKD.

关 键 词：2型糖尿病 糖尿病肾脏疾病 中性粒细胞明胶酶相关脂质运载蛋白 

分 类 号：R587.1[医药卫生—内分泌]