尿三叶因子3联合尿微量白蛋白、α1微球蛋白、转铁蛋白对糖尿病肾病的诊断价值  

Urine trefoil tactor 3 combined with microalbumin,α1 microglobulin,and transferrin in diagnosis of diabetic nephropathy

作　　者：姚燕珍[1] 李翊卫[1] 鲍舟君[1] 徐岳军[1] 竺王玉[2] YAO Yanzhen;LI Yiwei;BAO Zhoujun(Clinical Laboratory,Zhoushan Hospital,Zhoushan 316021,China)

机构地区：[1]浙江省舟山医院检验中心,316021 [2]浙江省舟山医院细胞分子生物实验室

出　　处：《浙江医学》2020年第11期1127-1130,1134,I0006,共6页Zhejiang Medical Journal

基　　金：舟山市医药卫生科技计划项目(2015B02)。

摘　　要：目的探讨尿三叶因子3(UTFF3)联合尿微量白蛋白(UAlb)、尿α1微球蛋白(UA1M)、尿转铁蛋白(UTf)对糖尿病肾病的诊断价值。方法选取糖尿糖肾病患者93例为研究对象,以43例健康体检者为对照。采用酶联免疫吸附试验检测两者UTFF3水平,特定蛋白分析仪检测UAlb、UA1M、UTf水平,并采用尿肌酐值(UCr)进行校正,受试者工作特征(ROC)曲线分析各指标及联合预测值在糖尿病肾病中的诊断价值。结果ROC曲线显示在糖尿病肾病诊断中UTFF3、UAlb、UA1M和UTf及联合预测值的曲线下面积(AUC)为0.926、0.931、0.844、0.882、0.956,灵敏度和特异度分别为0.8172、0.8387、0.6344、0.8495、0.8925和1.0000、0.9070、0.9070、0.7907、0.9302,差异均有统计学意义(均P<0.05);在早期糖尿病肾病诊断中,AUC分别为0.894、0.889、0.766、0.810、0.930,灵敏度和特异度分别为0.7931、0.8103、0.7241、0.7586、0.8276和0.9535、0.8605、0.6977、0.7907、0.9302,差异均有统计学意义(均P<0.05)。联合预测值AUC明显高于单个检测项目,差异有统计学意义(均P<0.05)。多因素logistic回归分析表明UTFF3为早期糖尿病肾病的独立危险因素(P<0.05)。结论UTFF3是诊断糖尿病肾病的有效生物标志物,联合UAlb、UA1M和UTf具有更高的诊断价值。Objective To assess the diagnostic value of urinary trefoil factor 3(UTFF3)combined with urinary microalbumin(UAlb),urinaryα1 microglobulin(UA1M)and urinary transferrin(UTf)in diabetic nephropathy.Methods Ninety-three patients with diabetic nephropathy were selected as the study objects,and forty-three healthy physical examination subjects were selected as the control group.The levels of UTFF3 were detected by enzyme-linked immunosorbent assay(ELISA),and the levels of UAlb,UA1M and UTf were measured by specific protein analyzer.The results were corrected by urinary creatinine(UCr).The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of each factors and their combination in predicting diabetic nephropathy.Results The ROC curve showed that the areas under the curve(AUC)of UTFF3/UCr,UAlb/UCr,UA1M/UCr and UTf/UCr and their combination in predicting diabetic nephropathy were 0.926,0.931,0.844,0.882,0.956,respectively,and the sensitivity and specificity were 0.8172,0.8387,0.6344,0.8495,0.8925 and 1.0000,0.9070,0.9070,0.7907,0.9302,respectively(all P<0.05).In early stage of diabetic nephropathy,the AUCs were 0.894,0.889,0.766,0.810,0.930,respectively;and the sensitivity and specificity were 0.7931,0.8103,0.7241,0.7586,0.8276 and 0.9535,0.8605,0.6977,0.7907,0.9302,respectively(all P<0.05).The AUC of combination was significantly higher than those of single factor(P<0.05).Multivariable logistic regression analysis showed that UTFF3 was potential predictor for the early stage of diabetic nephropathy(P<0.05).Conclusion UTFF3 is a new effective biomarker for the diagnosis of diabetic nephropathy.Moreover,UTFF3 combined with microalbumin,α1 microglobulin and transferring has higher diagnostic value and worthy for the clinical application.

关 键 词：糖尿病肾病 三叶因子3 微量白蛋白 Α1微球蛋白 尿液 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]